{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T12:48:54Z","timestamp":1764679734711,"version":"3.46.0"},"reference-count":19,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T00:00:00Z","timestamp":1764633600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Background: Hepatitis B virus (HBV) and Plasmodium falciparum infections remain major public health concerns in sub-Saharan Africa, especially among pregnant women, who are particularly vulnerable due to physiological immunomodulation. While mono-infections are well documented, the burden and biological consequences of HBV\u2013P. falciparum co-infection during pregnancy remain under-investigated in Gabon. Aim: To determine the prevalence, clinical relevance, and biochemical impact of HBV\u2013P. falciparum co-infection among pregnant women in Libreville, Gabon, and to explore the interaction between viral and parasitic replication. Methods: A prospective cross-sectional study was conducted between May 2022 and May 2023 at the CHUME-FJE Laboratory in Libreville. Serum samples were tested for HBsAg using rapid diagnostic tests and ELISA confirmation; HBV surface antigen (HBsAg) levels were quantified by electrochemiluminescence (ECLIA). Parasitemia was assessed by rapid diagnostic test, microscopy, and the Lambar\u00e9n\u00e9 thick blood film method. Liver function parameters (ALT, AST, ALP, and GGT) were evaluated using an automated biochemistry analyzer. Statistical analysis included Mann\u2013Whitney U tests, chi-square tests and Spearman\u2019s rank correlation coefficient with significance set at p &lt; 0.05. Results: Of the 222 pregnant women enrolled, HBV infection was detected in 9 cases (4.05%). Among these, 6 (2.7% of the study population) were mono-infected with HBV, while 3 (1.35%) were co-infected with Plasmodium falciparum. P. falciparum parasitemia was detected in 58 cases (26.1%). Biochemical profiles revealed elevated transaminases (AST) in HBV mono-infected women, while liver enzymes remained within normal ranges in co-infected individuals. Quantitative analyses demonstrated an inverse relationship between HBV surface antigen levels and P. falciparum parasitemia. This observation could suggest an antagonistic replication dynamic. However, the relationship was not statistically significant (Spearman\u2019s \u03c1 = \u22120.5, p = 0.67). Conclusions: HBV and P. falciparum co-infection occurs in a small but clinically relevant proportion of pregnant women in Gabon. The observed inverse replication pattern suggests a potential biological antagonism that may modulate disease severity. These findings although preliminary, could highlight the need for integrated screening and management strategies during pregnancy to improve maternal and fetal outcomes.<\/jats:p>","DOI":"10.3390\/v17121576","type":"journal-article","created":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T12:39:43Z","timestamp":1764679183000},"page":"1576","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Hepatitis B Virus and Plasmodium falciparum Co-Infection Among Pregnant Women in Gabon: Prevalence, Biochemical Impact, and Antagonistic Replication Dynamics"],"prefix":"10.3390","volume":"17","author":[{"given":"Aude Sandrine","family":"Andeme Eyi","sequence":"first","affiliation":[{"name":"Laboratoire du Centre Hospitalier, Universitaire M\u00e8re-Enfant Fondation Jeanne Ebori, Libreville BP 20000, Gabon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isma\u00ebl Pierrick","family":"Mikelet Boussoukou","sequence":"additional","affiliation":[{"name":"Laboratoire du Centre Hospitalier, Universitaire M\u00e8re-Enfant Fondation Jeanne Ebori, Libreville BP 20000, Gabon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Serge Thierry","family":"Omouessi","sequence":"additional","affiliation":[{"name":"D\u00e9partement de Physiologie, Facult\u00e9 de M\u00e9decine, Universit\u00e9 des Sciences de la Sant\u00e9, Libreville BP 20000, Gabon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean Alban","family":"Ondh Obame","sequence":"additional","affiliation":[{"name":"D\u00e9partement de SVT, Ecole Normale Sup\u00e9rieur, Libreville BP 20000, Gabon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Opheelia","family":"Makoyo Komba","sequence":"additional","affiliation":[{"name":"Service de Gyn\u00e9cologie du Centre Hospitalier, Universitaire M\u00e8re-Enfant Fondation Jeanne Ebori, Libreville BP 20000, Gabon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joel Fleury","family":"Djoba Siawaya","sequence":"additional","affiliation":[{"name":"Laboratoire du Centre Hospitalier, Universitaire M\u00e8re-Enfant Fondation Jeanne Ebori, Libreville BP 20000, Gabon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-0536-886X","authenticated-orcid":false,"given":"B\u00e9n\u00e9dicte","family":"Ndeboko","sequence":"additional","affiliation":[{"name":"Laboratoire du Centre Hospitalier, Universitaire M\u00e8re-Enfant Fondation Jeanne Ebori, Libreville BP 20000, Gabon"},{"name":"D\u00e9partement de Biologie Cellulaire & Mol\u00e9culaire, G\u00e9n\u00e9tique, Facult\u00e9 de M\u00e9decine, Universit\u00e9 des Sciences de la Sant\u00e9, Libreville BP 20000, Gabon"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,2]]},"reference":[{"key":"ref_1","first-page":"1333","article-title":"Global epidemiology of hepatitis B virus infection: New estimates of age-specific HBsAg seroprevalence and endemicity","volume":"57","author":"Ott","year":"2012","journal-title":"Hepatology"},{"key":"ref_2","unstructured":"World Health Organization (WHO) (2020). 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