Preprints.org logo
Preprint
Brief Report

This version is not peer-reviewed.

Prevalence of Hepatitis B Virus Infection Among Selected Pregnant Women Attending Antenatal Care a Within a Community Setting South-West Nigeria

Submitted:

15 June 2026

Posted:

29 June 2026

You are already at the latest version

Abstract
The prevalence of HBV infection is increasing in our community particularly among pregnant women due to the high risk of vertical transmission. This study determine the prevalence of Hepatitis B surface antigen (HBsAg) among pregnant women attending selected antenatal care hospitals within Ede community, Osun State, Nigeria. A total of one-hundred & eighty (180) consenting pregnant women were recruited for the study. Blood samples were collected and analyzed using ELISA for HBsAg detection. Liver function was assessed in seropositive individuals using Alanine Aminotransferase (ALT) levels. The overall prevalence of HBsAg was 15.6% (28/180). Subjects aged 26–33 years had the highest rate of positivity at 50% of all positive cases. Statistical analysis showed a significant association between HBV infection and age group (χ² = 14.694, p = 0.618), blood transfusion (χ² = 0.972, p = 0.615), herbal medicine use (χ² = 1.843, p = 0.398), alcohol consumption (χ² = 0.291, p = 0.589), HBV awareness (χ² = 2.710, p = 0.100), vaccination status (χ² = 3.070, p = 0.576), and pregnancy per trimester (χ² = 1.126, p = 0.569). However, there was a statistical significant positive correlation between HBV infection and elevated ALT levels (r = 0.489, p = 0.007), suggesting possible liver inflammation among infected individuals. Findings shows that the prevalence appears unusually high among the study population. This emphasizes the need for routine antenatal screening and improved public awareness. Early detection can aid in reducing vertical transmission and ensuring better maternal and neonatal outcomes.
Keywords: 
prevalence
;  
hepatitis B virus
;  
infection
;  
pregnant women
;  
antenatal care
;  
community setting
Subject: 
Biology and Life Sciences  -   Immunology and Microbiology

1. Introduction

Hepatitis B virus (HBV) infection has assumed a global public health concern. However, it is realized that current burden of chronic HBV infection varies geographically [1]. It has been estimated that about 5-15% of adults in sub-Saharan Africa are chronically infected with HBV infection, which has assumed a worrisome dimensions. [2]. Research also showed that about 15-25% of those infected with HBV are more at risk of further complications and eventual death in adulthood from HBV-related cirrhosis and hepatocellular carcinoma. However, a proportion of infected population with acute infections may end up with complications including fulminant liver failure [3]. In populations of high endemicity, it is has been estimated almost 8% of the population end up as chronic HBV carriers. Transmission process shows that HBV is mainly contracted at birth and early childhood, while perinatal transmission from an infected mother to child has become a major concern. [4]. Studies has asserted that of the 90% of infected individuals during the prenatal period; 30% of these population are mostly infected in early childhood, while about 6% of those infected after 5 years of age develop chronic infection [5].In undeveloped countries of the world with high or moderate endemicity, it has been found that vertical transmission from mother to child and horizontal transmission among children, particularly siblings, are the commonest identified routes of HBV infection [6]. Studies has shown that about 70–90% Neonates born to mothers with chronic HBV infection are at a higher risk of progressing to a chronic phase of infectivity [7].
Research has shown that most HBV resultant complications and eventual a deaths among adults might be due to infections acquired at birth [8]. It has been researched that infected children above 5 years of age rarely develop chronic conditions [9]. The prevention of mother-to-child transmission of this infectious agent is a critical step at reducing the global burden of chronic HBV [7]. Infection with HBV among children at particularly among children has assumed a most important predictor of chronic status and those infected. However, 15 - 40 % of individuals that develops chronic HBV infection, may eventually end up with a higher risk of developing further complications [7].This chronic status of infected individuals is mostly attributed to the immature immune system of such population. Furthermore, it has been estimated that more than 95% of infected adults spontaneously recover from an acute HBV infection, which is evidenced by the clearance of the HBsAg from the blood, which further defines the level of the host immune response [10].
It has also been studied that blood transfusion has been implicated as a major route of HBV transmission among the general population especially in pregnant women. Other transmission route of this infectious agent is discovered among the population that engage in heterosexual lifestyle especially in sub-Saharan Africa [11]. It has been realized from studies that significant differences exist with regards to the level of infectivity between pregnant women who had received blood transfusion compared to those who had not, this is as observed in the studies reported by [12]. Despite the availability of HBV vaccines; it has been realized that low level of vaccine awareness or even unavailability and the eventual high cost of these HBV vaccines particularly in developing nations are draw backs to the prevention of this the HBV transmission in the population. Another concern is with the fact that the development of immunization-related challenges has also affected the success of the immunization regimen among pregnant women in Nigeria. This unfortunately has resulted in the upward trends of HBV Infection observed in recent years across most developing countries [13].
Research has proved that the causes of maternal and complications in newborns are multifactorial. Hence, studies has also shown that Hepatitis B virus infection, may have a significant implications for both the mother and the developing fetus, this may eventually result in complications such as preterm labor, low birth weight, preeclampsia, anemia of pregnancy, and even maternal and neonatal mortality.
This study addresses an urgent need to determine the prevalence of HBV among pregnant women at our study location. This is in furtherance to estimating transmission risk of the virus to newborns and to reduce the overall burden of the vial infection in the community.

2. Methodology

Study Area

Osogbo (rarely Oshogbo) is a city in Osun State, Nigeria in 1991 [14]. Osogbo city seats the Headquarters of both Osogbo Local Government Area (situated at Oke Baale Area of the city) and Olorunda Local Government Area (situated at Igbonna Area of the city) [15]. It is some 88 kilometers by road northeast of Ibadan. It is also 108 kilometers (67 mi) by road south of Ilorin (Kwara State) and 108 kilometers (67 mi) northwest of Akure [14]. Osogbo shares boundaries with Ikirun, Ilesa, Ede, Egbedore, Ogbomosho, and Iragbiji and is easily accessible from any part of the state because of its central nature [15]. It is about 48 km from Ife, 32 km from Ilesa, 46 km from Iwo, 48 km from Ikire, and 46 km from Ila-Orangun. The city has a population of about 500,000 people and an approximate land area of 2875 km2 the postal code of the area is 230 [14]. This study was carried out at UNIOSUN Teaching Hospital, Asubiaro hospital and Peace Cottage Hospital Osogbo, Osun state.

Study Design

It was a cross-sectional study, which involved laboratory analysis of data collected from the population in Asubiaro hospital and Peace Cottage Hospital Osogbo, Osun state.

Study Population

The study population icluded pregnant women attending the Antenatal clinic in Asubiaro hospital and Peace Cottage Hospital in Osogbo, Osun State. During the study period, all pregnant women who gave informed consent and satisfied the study inclusion criteria were recruited into the study.

Ethical Consideration

Approval for this study was obtained from Adeleke University Ethical Board. The sample collection protocols were explained to the consenting participants using the information sheet prepared by the researcher. Each patient was required to give written informed consent before being engaged in the study.

Sample Size Determination

The sample size was calculated using Leslie Fisher sample size calculation:
Sample size n=Z2 X P.1-Pd2
Where n = desired sample size,
Z = Standard normal variate (at 5% type 1 error (P < 0.05) it is 1.96 and at 1% type 1 error (P < 0.01) it is 2.58). As in the majority of studies, p values are considered below 0.05 hence 1.96 is used in the formula.
P = Prevalence of diabetic individuals in Nigeria is 3.6% (International Diabetes Federation IDF, 2021).
d = Absolute error or precision (5% as decided by the researcher).
Sample size n=1.962 X 0.0821-0.0820.052
n= 3.8416 X 0.0820.9180.0025
n=116
The minimum sample size for this study = 116

Sample Collection

Three milliliter (3ml) of blood samples were collected aseptically by venipuncture. Each blood sample obtained was transferred into a carefully labeled plastic microliter tube containing ethylene diamine tetra acetic acid (EDTA) and Lithium Heparin bottle and stored in the refrigerator at 40C. Each resultant supernatant (Plasma) was carefully decanted into a new labeled tube and stored at -20°C prior use.

Laboratory Diagnosis

Elisa (Enzyme Linked Immunosorbent Assay)

Reagents preparation: the reagents were allowed to reach room temperature (18-30°C). The Wash buffer was checked and concentrated for the presence of salt crystals. In the presence of crystals it was solubilized and warmed at 37°C until crystals dissolve.
Three wells were marked as Negative control (e.g. B1, C1, D1), two wells as Positive control (e.g. E1, F1) and one Blank (e.g. A1, neither samples nor HRP-Conjugate was added into the Blank well). Using separate disposal pipette tips for each specimen, negative and positive control to avoid cross contamination 50μl of Positive control, Negative control, and Specimen was added into their respective wells except the Blank. It was mixed by tapping the plate gently. 50μl of HRP-Conjugate was added into each well except the Blank, and it was mixed by tapping the plate gently. The plate was covered with the plate cover and incubated for 60 minutes at 37°C. The plate covers was then removed and discarded after incubation. It was washed well 5 times with diluted Washing buffer. The micro wells were allowed to soak for 30-50 seconds each time during the 5 times washing. The plate was turned down on blotting paper and tapped gently to remove any remainders. 50μl of Chromogen A and 50μl Chromogen B solutions was added into each well including the Blank. It was Incubated e at 37°C for 15 minutes avoiding light. The enzymatic reaction between the Chromogen solutions and the HRP-Conjugate produced blue color in Positive control and HBsAg positive sample wells. A multichannel pipette was used to add 50μl of Stop Solution into each well and mixed gently. Intensive yellow color developed in Positive control and HBsAg positive sample wells. The plate reader was calibrated with the Blank well and absorbance was read at 450nm.

Liver Function Testing (Alanine Amino Transferase) on Sero Positive Samples

The reagents were stored at 2-8c and brought to room temperature (15-25) before it was used.1000 microliter of reagent 1 was pipetted into the test tubes and 250 microliter of reagent 2 was added. It was incubated for 10 minutes at room temperature. 250 microliter of reagent 3 was added to the samples and incubated again for 5 minutes at room temperature. The absorbance was read at 340nm against the reagent blank.

Statistical Analysis

The data was analyzed using the Statistical Package for Social Sciences (SPSS) Version 28 statistical package. The data were presented in tables as frequency and percentages.

3. Result

3.1. Distribution of HBsAg Within the Population Screened (N=180)

Table 3.1 shows the distribution of HBsAg among the one hundred and eighty pregnant women screened, 28 of them positive representing 15.6% while 152 representing 84.4% were negative (Figure 3).
Table 3.1. Distribution of HbsAg within the population screened (N=180).
Table 3.1. Distribution of HbsAg within the population screened (N=180).
Location Positive (%) Negative (%) Total
Ede, Osun state 28(15.6) 152 (84.4) 180

3.2. Distribution of HbsAg Based on the Age Group of Subjects Screened

Table 3.2 shows the distribution of HBsAg based on age, its subject age (26-33) recorded a higher prevalence of 50%.
Age group Positive (%) Negative (%) Total tested Chi square p. value
18-25 2(7.1) 20(13.2) 22 14.694 0.618
26-33 14(50) 70(46) 84
34-40 10(3.5) 53(34.9) 63
41-47 2(7.1) 9(5.9) 11
Table 3.3 Showed the lifestyle choices of the screened pregnant women, with regards to alcohol and herbal consumption. A significant majority of 170 ((96%), respondents reported abstinence from both alcohol and herbal products during their pregnancy, compared to (1%) that admitted to consuming alcohol. A slightly larger group of 8 women (5%) indicated they used herbs during their pregnancy. With regards to blood transfusion, majority of the respondents, 159 (88%), indicated that they had not received blood transfusion. Compared to 19 respondents (11%) who indicated an evidence of blood transfusion.
Table 3.3. Distribution based on lifestyle and HbsAg infectivity.
Table 3.3. Distribution based on lifestyle and HbsAg infectivity.
Risk factors No. Screened (%) Positive (%) Negative (%) Chi square (X2) p.value
History of Blood Transfusion 0.972 0.615
Yes 19(10.6) 2(7.1) 16(9.7)
No 159(88.3) 26(92.9) 133(80.6)
Lifestyle 1.843 0.398
Herbal medicine (yes) 8(4.4) 2(7.1) 6(3.9)
Herbal medicine (No) 172(95.6) 26(92.9) 146(96.0)
Alcohol(yes) 2 (9.1) 1(0.2) 1(1.5)
Alcohol (no) 178(98.9) 27(7.6) 151(83.9)

3.4. Distribution Based on Clinical History, Awareness and HbsAg Infectivity

Table 3.4 shows the awareness levels of Hepatitis B Virus (HBV) among the study participants. The data reveal a significant disparity in HBV knowledge. A total of 76 (42%) respondents reported a lack of awareness regarding HBV. In contrast, a majority of the participants 104 (57%) indicated awareness for HBV. This highlights that while awareness exists, a considerable segment of pregnant women remains uninformed about this potentially harmful virus. It also shows the pregnant women's knowledge regarding the Hepatitis B Virus (HBV) vaccine. The results indicate a significant gap in understanding among the respondents. Out of the total sample of 180, a notable portion, 73 women (40%), expressed uncertainty about the vaccine. A larger segment, comprising 74 women (41%), lacked knowledge about the HBV vaccine and answered negatively when asked about it. Few respondents, 33(18%), demonstrated awareness and responded affirmatively, indicating they possessed knowledge of the HBV vaccine.
Table 3.4. Distribution based on clinical history, awareness and HbsAg infectivity.
Table 3.4. Distribution based on clinical history, awareness and HbsAg infectivity.
Knowledge of HBV No of people tested (%) Chi square (X2) p-value
Aware 76(42.2) 2.710 0.100
Unaware 104(57.8)
Awareness of Vaccine 3.070 0.576
Yes 33(18.3)
No 74(41.1)
Unsure 73(40.6)
Table 3.5. Distribution of HbsAg infectivity based on trimesters of the pregnant women screened.
Table 3.5. Distribution of HbsAg infectivity based on trimesters of the pregnant women screened.
Trimester No of people tested Positive (%0) Negative (%) Chi-square p-value
First trimester 48(26.7) 10(35.7) 38(25) 1.126 0.569
Second trimester 68(37.8) 9(32.1) 59(38.9)
Third trimester 64(35.6) 9(32.1) 55(36.2)

3.6. Distribution of HbsAg Infectivity and ALT Levels of the Respondents

Table 3.6 represents a Correlation between HBV Infection and ALT Levels in sero-positive Pregnant Women.
Table 3.6. Correlation between HBV sero positive samples and ALT testing.
Table 3.6. Correlation between HBV sero positive samples and ALT testing.
HBV R 0.489**
P 0.007
Table 3.7. Mean±standard deviation (Mean ± SD) of HBV and ALT in pregnant women.
Table 3.7. Mean±standard deviation (Mean ± SD) of HBV and ALT in pregnant women.
Mean± SD P-value
HBV 0.760 ± 0.093 0.002
ALT 35.44 ± 8.587 0.076

4. Discussion

Findings from this study showed (15.6%) level of positivity among the population screened. The result obtained is significant when compared with a relative study in Osun state which showed that prevalence increased from 5.8% in 2021 to 6.7% in 2023 [16] and [17] respectively.
The reported prevalence in this study is a cause for concern, which advocates routine antenatal screening among the intending mothers. More so, HBV positive pregnant women has been found to represent a major reservoir of the virus especially in endemic communities, which might put the unborn fetus at a higher risk of infection.
In this study respondents aged 26-33 years recorded 7.8% prevalence compared to other age group category, this is however contrary to report by [17] who recorded 2.0% which is significantly higher among pregnant women aged 18-25. The resultant high prevalence among this age group in this study may be attributed to the fact that this age group represents the active reproductive age bracket. Similarly, the age range corresponds with peak sexual activity, potentially increasing exposure risk [18]. Studies has also affirmed that age is an important factor in such epidemiological studies. Hence a major determinant of the incidence of HBV among the population studied.
Most of the women in the 1st trimester had the highest HBsAg seropositivity of 5.6% the result obtained is lower than those of [19] who obtained a prevalence of 5.3% among those within the1st trimester of pregnancy, this finding did not show any statistical significance. However it is crucial to ensure acute HBV infection is differentiated from other acute liver diseases that occur during pregnancy such as intrahepatic cholestasis to guide accurate treatment at especially at the first trimester of pregnancy.
Subjects with history of blood transfusion recorded 7.1% seropositivity, this risk factor associated among our study population may seem low with a recorded statistical p-value >0.05 compared to other risk factors associated with HBV and blood transfusion in as shown in (Table 3.3) though not significant, However this finding is in contrast to the study conducted [20] where, history of blood transfusion emerged as a significant risk factor for HBV infection among pregnant women. Possible risk factors to blood transfusion from the observed subjects could be attributed to the lack of adherence to ethical protocols in blood collection and storage practices, which potentially lead to the use of infected blood in transfusions.
Subjects screened with history of alcoholic consumption and intake of herbal medicines recorded no statistical significant, however, Hepatitis B virus (HBV) and alcohol consumption and abuse may contribute to the development of end-stage liver disease, which may hasten progression of HBV infectivity among infected pregnant women. More so, research has proved that alcohol is a known teratogen and associated with a range of adverse outcomes for pregnant women and children exposed in utero [21]
In a similar studies conducted by, [22], it was observed that ALT elevation in HBV-positive pregnant women could predict disease progression and help guide antiviral therapy decisions. Findings from this study with regards ALT elevation among some sero-posotive subjects, are consistent with studies who reported that pregnant women with HBV infection tend to exhibit elevated ALT levels due to immune-mediated liver inflammation during pregnancy. Hepatitis B virus (HBV) infection demonstrates a significant positive correlation with alanine aminotransferase (ALT) levels in pregnant women. [23].
This suggests that HBV infection is associated with liver inflammation and potential liver damage during pregnancy, establishing ALT as a key indicator in liver health. However, it should be noted that during pregnancy, several modifications in the maternal immune system may occur with a shift in the Th1-Th2 balance towards a Th2 response, which increases the amounts of regulatory T cells, resulting in a depressed immune response against HBV. These modifications is aimed to prevent the rejection of the fetus who is already partially allogenic to the mother’s immune system. These modifications result in an increase of HBV DNA and a reduction of aminotransferase levels. After delivery it is observed that the immune system is restored back, thereby reversing the consequences, with a significant increase in alanine aminotransferase (ALT) and a corresponding reduction of HBV DNA at this period [23].
With regards to the awareness of HBV, (42.2%) of our respondents claimed awareness of the HB virus, while (57.8%) of the respondents denied knowledge of the virus. This suggests that larger number of the respondents from our study population were unfamiliar with the infective nature of the virus, this outcome underscores a significant knowledge gap, which may increase the risk of vertical transmission, however, in a study conducted by [24], it was observed that in most African countries, HBV knowledge remains poor despite global efforts to improve communication on viral hepatitis, which calls for more awareness on specific prevention components such as the need for maternal HBV testing and infant vaccination was relatively better.
Findings from this study shows that just about 18% of the respondents, are aware of the availability of vaccines against HBV infection, This agrees with the observations of [25] and [26], who noted that antenatal care frameworks should further emphasize mother-to child transmission prevention, thereby improving maternal recognition of testing and vaccination needs. This study suggest an urgent need for improved enlightenment and awareness among the study population with regards the availability of HBV vaccine at the commencement of antenatal visits. Furthermore, while our study respondents demonstrated moderate partial awareness of HBV prevention, significant gaps persist in accurate knowledge, vaccination uptake, and testing practice which should be bridged by healthcare policy makers.

5. Conclusion

The findings from this study advocates an urgent implementation of routine screening for pregnant women, improved public awareness, and widespread vaccination. These timely intervention protocols are critical for minimizing maternal morbidity and preventing perinatal HBV transmission among the populace. The following is however recommended towards enhancing prompt intervention by policy makers and Heath care practitioners: Further Research on a larger-scale, multi-center studies is strongly advocated to evaluate the dynamics of HBV and liver function across different trimesters and ethnic groups.

Author Contributions

Data curation: GCO, CJN. Formal analysis: GCO. Investigation: JAN. Project administration: JAN, TOO. Supervision: JAN Validation: JAN, BNE. Writing original draft GCO. Writing – review & editing: SIA, CJN.
All authors have seen and approved the submitted version of this manuscript.

Funding

This project was self-funded.

Data Availability Statement

Data will be made available on reasonable request.

Acknowledgments

The authors would like to thank all the volunteers for willing to participate in this study. We thank all the Medical Laboratory Scientist at the MLS Department of Adeleke University who assisted in the data collection for this study. Also acknowledged are the Nurses and Midwives at the two antenatal facilities for the cooperation rendered,

Conflicts of Interest

The authors declare no conflicts of interest.” or in the decision to publish the results”. The authors declare that they have no competing interests

References

  1. Riches, N.; Abayomi, A.; Smith, J. Hepatitis B in sub-Saharan Africa: Challenges in diagnosis and management. Afr. J. Lab. Med. 2025, 14(1), 1–10. [Google Scholar]
  2. Rizzo, G. E. M.; Cabibbo, G.; Craxì, A. Hepatitis B virus-associated hepatocellular carcinoma. Viruses 2022, 14(5), 986. [Google Scholar] [CrossRef] [PubMed]
  3. Malungu, J. A. Prevalence of Hepatitis B virus, social demographic factors and circulating genotypes among antenatal clinic attendees at Mbagathi County Referral Hospital. Doctoral dissertation, University of Nairobi, 2022. [Google Scholar]
  4. Timub, K.; Doe, J.; Mensah, F. Vertical transmission of hepatitis B virus: A review of the biological pathways. J. Neonatal Biol. 2020, 9(3), 234. [Google Scholar]
  5. Poddar, U.; Benjamin, M.; Aggarwal, R.; Sarangi, A. N.; Mathias, A.; Yachha, S. K.; Srivastava, A. Hepatitis B transmission: Is vertical transmission the major route in intermediate endemic areas? A proof-of-concept study based on mother–child genotypes. Am. J. Trop. Med. Hyg. 2021, 105(6), 1569–1574. [Google Scholar] [PubMed]
  6. Terrault, N. A.; Levy, M. T.; Cheung, K. W.; Jourdain, G. Viral hepatitis and pregnancy. Nat. Rev. Gastroenterol. Hepatol. 2021, 18(2), 117–130. [Google Scholar] [CrossRef] [PubMed]
  7. Hsu, Y. C.; Huang, D. Q.; Nguyen, M. H. Global burden of hepatitis B virus: Current status, missed opportunities and a call for action. Nat. Rev. Gastroenterol. Hepatol. 2023, 20(8), 524–537. [Google Scholar] [CrossRef] [PubMed]
  8. Casanova, J. L.; Abel, L. from rare disorders of immunity to common determinants of infection: Following the mechanistic thread. Cell 2022, 185(17), 3086–3103. [Google Scholar] [CrossRef] [PubMed]
  9. Ma, H.; Yan, Q. Z.; Ma, J. R.; Li, D. F.; Yang, J. L. Overview of the immunological mechanisms in hepatitis B virus reactivation: Implications for disease progression and management strategies. World J. Gastroenterol. 2024, 30(10), 1295–1311. [Google Scholar] [CrossRef] [PubMed]
  10. Ademuyiwa, A. E.; Muhibi, M. A.; Ademulegun, F. G. Transmission of Hepatitis B Virus (HBV) through Blood Transfusion. Sokoto J. Med. Lab. Sci. 2024, 9(4), 265–270. [Google Scholar]
  11. Yirsaw, B. G.; Agimas, M. C.; Alemu, G. G.; Tesfie, T. K.; Derseh, N. M.; Abuhay, H. W.; Yismaw, G. A. Prevalence of Hepatitis B virus infection and its determinants among pregnant women in East Africa: Systematic review and Meta-analysis. PLoS ONE 2024, 19(7), e0307102. [Google Scholar] [CrossRef] [PubMed]
  12. Chukwurah, E. F.; Obeagu, E. I.; Ibe, E. C. Hepatitis B vaccination in Nigeria: Challenges and prospects. J. Med. Lab. Sci. 2023, 33(3), 204–210. [Google Scholar]
  13. Olayiwola, A. M.; Olaitan, O. Spatial preference of urban residential location in Osogbo, Nigeria. Ghana J. Geogr. 2019, 11(1), 140–158. [Google Scholar]
  14. Oladejo, S.; Ogunbiyi. Spatial modeling of malaria severity zones using malaria risk factors in Osogbo Municipal, Nigeria: GIS Approach; 2018. [Google Scholar]
  15. Olayinka, O. A.; Muhibi, M. A.; Adejumo, O. O. Seroprevalence and associated risk factors for Hepatitis B virus among pregnant women attending a public health facility in Osogbo, Nigeria. Rwanda J. Med. Health Sci. 2023, 6(2), 195–203. [Google Scholar] [CrossRef]
  16. Ruth, M. E.; Ayara, P. A.; Abdulraham, A. O.; Ikeuejamoye, O. G.; Obeagu, E. I. Incidence of sexually transmitted infections among pregnant women in State Specialist Hospital Osogbo, South-Western Nigeria. J. Curr. Med. Res. 2024, 4(2), 112–118. [Google Scholar]
  17. Ajibola, O.; Idowu, A.; Israel, O. K.; Akande, R. O.; Aremu, A. O.; Olasinde, Y. T. Hepatitis B infection and risk factors among pregnant women and their male partners in the Baby Shower Programme in Nigeria: A cross-sectional study. Trop. Med. Int. Health 2021, 26(3), 316–326. [Google Scholar]
  18. Agboeze, J.; Onoh, R. C.; Iyoke, C. A.; Ajah, L. O.; Onoh, T. J. Prevalence and predictors of hepatitis B surface antigenemia among pregnant women in Abakaliki, South-East Nigeria. Int. J. Gynecol. Obstet. 2024, 164(1), 115–122. [Google Scholar]
  19. Wang, J.; Zhang, L.; Liu, X. Effects of hepatitis B virus infection and strategies for preventing mother-to-child transmission on maternal and fetal T-cell immunity. Front. Immunol. 2023, 14, 1122048. [Google Scholar] [PubMed]
  20. Jeele, M.O.O.; Addow, R.O.B.; Adan, F.N.; Jimale, L.H. Prevalence and risk factors associated with hepatitis B and hepatitis C infections among patients undergoing hemodialysis: a single-centre study in Somalia. Int. J. Nephrol. 2021. [Google Scholar] [CrossRef] [PubMed]
  21. Nykjaer, C.; Alwan, N.A.; Greenwood, D.C. Maternal alcohol intake prior to and during pregnancy and risk of adverse birth outcomes: evidence from a British cohort. J. Epidemiol. Community Heal. 2014, 68, 542–549. [Google Scholar] [CrossRef]
  22. Yi, W.; Pan, Y.; Shen, Y.; Cheng, J.; Huang, Y. A nonlinear relationship between ALT levels at delivery and the risk of postpartum ALT flares in pregnant women with chronic hepatitis B. Int. J. Med. Sci. 2023, 20(2), 247–25. [Google Scholar] [CrossRef]
  23. Ter-Borg, M.J.; Leemans, W.F.; De-Man, R.A.; Janssen, H.L. Exacerbation of chronic hepatitis B infection after delivery. J. Viral Hepat. 2008, 15, 37–41. [Google Scholar] [CrossRef] [PubMed]
  24. Dagnaw, M.; Muche, A.; Geremew, B. M. Epidemiology of hepatitis B virus infection: Prevalence, vaccine coverage and its barriers in Katagum Local Government Area, Bauchi State Nigeria. Sci. World J. 2025, 20(5), 123–134. [Google Scholar] [CrossRef]
  25. Kaewdech, A.; Charatcharoenwitthaya, P.; Piratvisuth, T. Asian perspective on hepatitis B virus and hepatitis C virus elimination. Viruses 2024, 16(12), 1234. [Google Scholar] [CrossRef]
  26. Orotta, M.; Munseri, P.; Massawe, R. V. Hepatitis B virus: Prevalence, vaccination coverage and immune responses to immunization among healthcare workers at Muhimbili National Hospital. PLoS ONE 2025, 20(1), e0281234. [Google Scholar] [CrossRef] [PubMed]
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content.
Copyright: This open access article is published under a Creative Commons CC BY 4.0 license, which permit the free download, distribution, and reuse, provided that the author and preprint are cited in any reuse.