25 The probability of vertical infection is, however, much increased when the mother is also positive for HBeAg.3 In one study, vertical transmission was seen in 65% of babies born to mothers who were positive for HBeAg compared selleck compound with 9.1% for babies born to mothers who were negative

for HBeAg.26 In Senegal, out of 21 infants born to HBsAg positive mothers, 11 were HBsAg positive at birth; and at 6–7 months, five of these were still strongly HBsAg positive and developed antibodies to HBsAg, HBcAg or HBeAg.27 At present, pregnant women in Uganda are not routinely screened for HBsAg, and the exposed newborns are not immunised at birth against HBV infection. This high prevalence rate of HBsAg positivity among asymptomatic pregnant women in our study shows that there are many infants born who are at high risk of becoming chronic hepatitis B carriers and dying of chronic liver disease at a young adult age in the future. This study is not without limitations. We did not test for hepatitis B core antibodies (anti-HBc) and HBV DNA; and so there could have been HBsAg negative individuals with isolated anti-HBc and occult HBV infection. However, a recent study among HIV infected pregnant women showed that pregnant women with isolated anti-HBc and occult HBV infection have very low HBV DNA levels and are thus at very low risk

to transmit HBV to their infants.28 We also did not perform high resolution abdominal ultrasound scans;nor did we carry out serial liver enzyme tests to determine which mothers had active hepatitis B infections and may require treatment themselves. However, we referred every mother who tested positive for HBsAg to a competent physician for consultation. Implications and recommendations Government and development partners in health need to pay special attention to the high prevalence of infection in this region in order to reduce the cost of care of chronic liver diseases including hepatocellular carcinoma in the future. There is a need to urgently introduce routine screening for HBV infection during pregnancy and provide vaccination at birth for the exposed infants in order to reduce incidences of perinatal

infections with HBV. We recommend further studies to better characterise the pattern of HBV infections among the younger age group (18–25 years). Results of such studies Anacetrapib might provide guidance on appropriate methods of interventions to reduce the incidence and prevalence of HBV among these younger populations. Conclusions There is a high prevalence of hepatitis B infection among pregnant women attending ANC in Gulu and Lacor Hospitals. A high proportion of the HBsAg positive mothers are also HBeAg positive and may be at an increased risk of transmitting HBV infection to their unborn babies. These babies are at high risk of becoming chronic carriers of HBV infections and subsequently increasing the population pool of the virus. Supplementary Material Author’s manuscript: Click here to view.(1.