{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T12:27:27Z","timestamp":1768566447267,"version":"3.49.0"},"posted":{"date-parts":[[2023,11,27]]},"group-title":"Infectious Diseases (except HIV\/AIDS)","reference-count":35,"publisher":"openRxiv","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2023,11,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:sec id=\"s21\">\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Despite routine infant vaccination and blood donor screening, the Democratic Republic of Congo (DRC) has high hepatitis B virus (HBV) prevalence compared to the United States and Europe. Through the cross-sectional Horizontal and Vertical Transmission of Hepatitis B (HOVER-HBV) study, we characterized household prevalence in DRC\u2019s capital, Kinshasa, to inform additional prevention efforts.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec id=\"s22\">\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We introduced HBV surface antigen (HBsAg) screening alongside existing HIV screening as part of routine antenatal care (ANC) in high-volume maternity clinics in Kinshasa. We recruited households of pregnant women who were HBsAg-positive and HBsAg-negative, defining households as \u201cexposed\u201d and \u201cunexposed,\u201d respectively. Household members underwent HBsAg testing and an epidemiological survey. We evaluated HBsAg prevalence and potential transmission correlates.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec id=\"s23\">\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We enrolled 1,006 participants from 200 households (100 exposed, 100 unexposed) across Kinshasa. HBsAg prevalence was more than twice as high in exposed households (5.0%; 95% CI: 2.8%-7.1%) as in unexposed households (1.9%; 0.6%-3.2%). Exposed direct offspring had 3.3 (0.9, 11.8) times the prevalence of unexposed direct offspring. Factors associated with HBsAg-positivity included older age, marriage, and having multiple recent partners or any new sexual partners among index mothers; and older age, lower household wealth, sharing nail clippers, and using street salons among exposed offspring.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec id=\"s24\">\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Vertical and horizontal HBV transmission within households is ongoing in Kinshasa. Factors associated with infection reveal opportunities for HBV prevention efforts, including perinatal prevention, protection during sexual contact, and sanitation of shared personal items.<\/jats:p>\n                <\/jats:sec>","DOI":"10.1101\/2023.11.27.23298863","type":"posted-content","created":{"date-parts":[[2023,11,28]],"date-time":"2023-11-28T01:45:14Z","timestamp":1701135914000},"source":"Crossref","is-referenced-by-count":0,"title":["Hepatitis B virus prevalence and transmission in the households of pregnant women in Kinshasa, Democratic Republic of Congo"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1315-0908","authenticated-orcid":false,"given":"Camille E.","family":"Morgan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick","family":"Ngimbi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alix JN","family":"Boisson-Walsh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Ntambua","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jolie","family":"Matondo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martine","family":"Tabala","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melchior Mwandaglirwa","family":"Kashamuka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Emch","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessie K.","family":"Edwards","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kimberly A.","family":"Powers","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linda","family":"James","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nana","family":"Mbonze","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samuel","family":"Mampunza","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcel","family":"Yotebieng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peyton","family":"Thompson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan B.","family":"Parr","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"54368","reference":[{"key":"#cr-split#-2023113002200583000_2023.11.27.23298863v1.1.1","unstructured":"World Health Organization. Global Progress Report on HIV, Viral Hepatitis and Sexually Transmitted Infections, 2021: Accountability for the Global Health Sector Strategies 2016- 2021: Actions for Impact: Web Annex 1: Key Data at a Glance. World Health Organization"},{"key":"#cr-split#-2023113002200583000_2023.11.27.23298863v1.1.2","unstructured":"2021. Accessed October 12, 2021. https:\/\/apps.who.int\/iris\/handle\/10665\/342808"},{"key":"2023113002200583000_2023.11.27.23298863v1.2","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(18)30056-6"},{"key":"2023113002200583000_2023.11.27.23298863v1.3","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(16)30204-3"},{"key":"2023113002200583000_2023.11.27.23298863v1.4","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1003068"},{"key":"2023113002200583000_2023.11.27.23298863v1.5","unstructured":"World Health Organization. WHO releases first-ever global guidance for country validation of viral hepatitis B and C elimination. Accessed July 14, 2021. https:\/\/www.who.int\/news\/item\/25-06-2021-who-releases-first-ever-global-guidance-for-country-validation-of-viral-hepatitis-b-and-c-elimination"},{"key":"2023113002200583000_2023.11.27.23298863v1.6","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.12220"},{"key":"2023113002200583000_2023.11.27.23298863v1.7","doi-asserted-by":"crossref","unstructured":"Edmunds\u2019 WJ , Medley\u2019 GF , Nokes DJ , O\u2019Callaghan CJ , Whittle HC , Hall\u2019 AJ . Epidemiological patterns of hepatitis B virus (HBV) in highly endemic areas. Published online 1996:13.","DOI":"10.1017\/S0950268800001497"},{"key":"2023113002200583000_2023.11.27.23298863v1.8","doi-asserted-by":"publisher","DOI":"10.1111\/liv.13625"},{"key":"2023113002200583000_2023.11.27.23298863v1.9","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8278(01)00064-2"},{"key":"2023113002200583000_2023.11.27.23298863v1.10","doi-asserted-by":"publisher","DOI":"10.1136\/gut.38.Suppl_2.S5"},{"key":"2023113002200583000_2023.11.27.23298863v1.11","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.18-0883"},{"key":"2023113002200583000_2023.11.27.23298863v1.12","unstructured":"Naughton B , Abramson R , Wang A , Kwan-Gett T . DRC Survey: An overview of demographics, health, and financial services in the Democratic Republic of the Congo. University of Washington Strategic Analysis, Research and Training (START) Center. Published online March 29, 2017."},{"key":"2023113002200583000_2023.11.27.23298863v1.13","doi-asserted-by":"publisher","DOI":"10.1007\/s10389-018-0894-8"},{"key":"2023113002200583000_2023.11.27.23298863v1.14","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0216293"},{"key":"2023113002200583000_2023.11.27.23298863v1.15","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.20-0804"},{"key":"2023113002200583000_2023.11.27.23298863v1.16","doi-asserted-by":"publisher","DOI":"10.4236\/wja.2015.52015"},{"key":"2023113002200583000_2023.11.27.23298863v1.17","doi-asserted-by":"publisher","DOI":"10.2486\/indhealth.2018-0166"},{"key":"2023113002200583000_2023.11.27.23298863v1.18","doi-asserted-by":"publisher","DOI":"10.1101\/2023.09.22.23295978"},{"key":"2023113002200583000_2023.11.27.23298863v1.19","unstructured":"UNICEF. UNICEF Data Warehouse, V1.15. WHO\/UNICEF estimates of national immunization coverage, 2021 revision: Democratic Republic of Congo, time period: 2020. Published 2021. Accessed June 19, 2023. https:\/\/data.unicef.org\/resources\/data_explorer\/unicef_f\/"},{"key":"2023113002200583000_2023.11.27.23298863v1.20","unstructured":"World Health Organization. Prevention of Mother-to-Child Transmission of Hepatitis B Virus: Guidelines on Antiviral Prophylaxis in Pregnancy. World Health Organization; 2020. Accessed November 20, 2022. https:\/\/apps.who.int\/iris\/handle\/10665\/333391"},{"key":"2023113002200583000_2023.11.27.23298863v1.21","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(21)00304-1"},{"key":"2023113002200583000_2023.11.27.23298863v1.22","doi-asserted-by":"publisher","DOI":"10.29392\/001c.35449"},{"key":"2023113002200583000_2023.11.27.23298863v1.23","unstructured":"Alere Medical Co., Ltd. Fact sheet: DETERMINETM HBsAg 2."},{"key":"2023113002200583000_2023.11.27.23298863v1.24","unstructured":"CDC. Hepatitis B FAQs | CDC. Centers for Disease Control and Prevention. Published October 27, 2020. Accessed June 14, 2021. https:\/\/www.cdc.gov\/hepatitis\/hbv\/bfaq.htm"},{"key":"2023113002200583000_2023.11.27.23298863v1.25","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a009474"},{"issue":"1","key":"2023113002200583000_2023.11.27.23298863v1.26","first-page":"22","article-title":"Detection of Hepatitis B Virus in Used Razor Blades by PCR","volume":"10","year":"2010","journal-title":"Hepat Mon"},{"key":"2023113002200583000_2023.11.27.23298863v1.27","doi-asserted-by":"publisher","DOI":"10.1155\/2020\/8578172"},{"key":"2023113002200583000_2023.11.27.23298863v1.28","unstructured":"The Government of the Democratic Republic of Congo. Annual progress report 2007 (English). Published online April 30, 2008. https:\/\/www.gavi.org\/sites\/default\/files\/document\/annual-progress-report-congo%2C-democratic-republic-of-the-2007pdf.pdf"},{"key":"2023113002200583000_2023.11.27.23298863v1.29","unstructured":"Le gouvernement de Republique Democratique du Congo. Rapport annuel de situation 2008. Published online Mai 2009. https:\/\/www.gavi.org\/sites\/default\/files\/document\/annual-progress-report-congo%2C-democratic-republic-of-the-2008--francais-pdf.pdf"},{"key":"2023113002200583000_2023.11.27.23298863v1.30","doi-asserted-by":"publisher","DOI":"10.1001\/archpediatrics.2009.31"},{"key":"2023113002200583000_2023.11.27.23298863v1.31","doi-asserted-by":"publisher","DOI":"10.1111\/liv.15390"},{"key":"2023113002200583000_2023.11.27.23298863v1.32","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.21.287015"},{"key":"2023113002200583000_2023.11.27.23298863v1.33","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyz037"},{"key":"2023113002200583000_2023.11.27.23298863v1.34","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0248218"}],"container-title":[],"original-title":[],"link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1101\/2023.11.27.23298863","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T19:45:36Z","timestamp":1768506336000},"score":1,"resource":{"primary":{"URL":"http:\/\/medrxiv.org\/lookup\/doi\/10.1101\/2023.11.27.23298863"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,27]]},"references-count":35,"URL":"https:\/\/doi.org\/10.1101\/2023.11.27.23298863","relation":{"is-preprint-of":[{"id-type":"doi","id":"10.1093\/ofid\/ofae150","asserted-by":"subject"}]},"subject":[],"published":{"date-parts":[[2023,11,27]]},"subtype":"preprint"}}