Author information

¹Laboratoire du Centre Hospitalier Universitaire Mère-Enfant Fondation Jeanne Ebori, Libreville, Gabon.

²Service de Gynécologie du Centre Hospitalier Universitaire Mère-Enfant Fondation Jeanne Ebori, Libreville, Gabon.

³U1052 INSERM, Lyon, France.

⁴Service Hépato-Gastro-Entérologie du CHUL, Libreville, Gabon.

⁵Département de Biologie Cellulaire & Moléculaire-Génétique, Faculté de Médecine, Université des sciences de la Santé, Libreville, Gabon.

Abstract

Objectives: Chronic hepatitis B virus (HBV) infection remains a major health problem worldwide. This infection is more severe when combined with hepatitis Delta virus (HDV). Moreover, Plasmodium falciparum (Pf) malaria infection during pregnancy can have severe consequences for the mother and the newborn. Importantly, the manifestation of these three infections has never been described to date.

Methods: Thus, we conducted a prospective study, between May 27, 2022, and April 15, 2023, and we investigated these three infections in 260 pregnant women aged 24 to 46 years, in Gabon and evaluated the impact on newborns. The sera were used to screen hepatitis B surface antigen (HBsAg) and Pf by determining HBsAg® ALERE rapid diagnostic test and malaria rapid diagnostic test kits. The positive sample was confirmed using MINI VIDAS® for HBV and Lambaréné method for "Pf". The real-time-polymerase chain reaction assay was used to amplify HBV DNA and HDV RNA on Roche instrument.

Results: Our results showed that the prevalences of HBV and (Pf) infection were 4.23% (n = 11) and 34.62% (n = 90), respectively. Moreover, we found that 3.46 % (n = 9) of pregnant women infected with HBV were coinfected with HDV. The prevalence of triple infection was 1.15% (n = 3). In addition, the leukocytes and lymphocytes absolute count were significantly lower for the triple-infected pregnant women.

Conclusions: We describe for the first time the triple coinfection by HBV, HDV, and Pf, which could induce a great inflammatory reaction and high liver disorder in newborns.