Hepatitis B virus Seroprevalence Among Heterosexual Couples Attending Antenatal Care at Gulu Regional Referral Hospital, Uganda

Background Hepatitis B virus (HBV) is a global health concern and the leading cause of chronic liver disease, including liver cirrhosis and hepatocellular carcinoma. The Uganda Ministry of health recommends screening of HBV for all pregnant mothers during antenatal care (ANC). However, limited literature exists regarding couple testing and outcomes, particularly in Northern Uganda. Objective We determined HBV seroprevalence and associated factors among pregnant women and their partner attending ANC clinic of Gulu Regional Referral hospital (GRRH), Gulu, Uganda. Methods Between 1st December 2023 and 28th February 2024, a hospital-based, cross-sectional study was conducted among eligible pregnant women and their male partners attending ANC of GRRH, Gulu, Uganda. Following systematic random sampling, pretested questionnaire was administered by an interviewer. Blood samples were collected for HBV surface antigen (HBsAg) rapid test, which was performed according to manufacturers instructions. Qualitative data was analysed using logistic regression in STATA version 15 SE. P<0.05 was considered statistically significant. Results A total of 242 couple pairs were enrolled. Overall, 8.3% (n=40) participants were seropositive for HBsAg; Male partners [M] (10.7%, n=26) and pregnant women [F] (5.8%, n=14). Sero-concordance (M negative [-ve] and F [-ve]; 83.5%, n=202), (M positive [+ve] and F [+ve]; 4.1%, n=10) and sero-discordance (M +ve and F -ve; 8.7%, n=21), (M -ve and F +ve; 3.7%, n=9). Factors associated with positive HBsAg were, being male (adjusted odds ratio [aOR]: 2.45, 95% Confidence Interval [CI], 1.15 - 5.21, p=0.02), daily alcohol consumption (aOR: 4.73, 95% CI: 1.40 -16.04, p=0.01), and no prior vaccination against HBV (aOR: 12.01, 95% CI: 4.07 - 35.65, p<0.001). Conclusion There is a high HBsAg seropositivity rate, particularly among male partners of pregnant women. There is an urgent need to have couples who come for ANC to be screened for HBV and to strengthen and sensitise young people for premarital HBV screening.