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Hepatitis B virus infection and vaccine coverage among children living with HIV, HIV-exposed uninfected, and HIV-unexposed uninfected children in the Western Cape, South Africa
Introduction: Limited evidence on the burden of hepatitis B virus (HBV) infection among children living with HIV (CLWH), HIV-exposed uninfected (HEU) and HIV-unexposed uninfected (HUU) children hinders progress towards eliminating hepatitis B as a public health threat in South Africa. Methods: This...
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| Format: | Thesis |
| Language: | English English |
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Department of Public Health and Family Medicine
2026
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| _version_ | 1869483658926096384 |
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| access_status_str | Open Access |
| author | Collins, Courteney Jade |
| author2 | Amponsah-Dacosta, Edina |
| author_browse | Amponsah-Dacosta, Edina Collins, Courteney Jade |
| author_facet | Amponsah-Dacosta, Edina Collins, Courteney Jade |
| author_sort | Collins, Courteney Jade |
| collection | Thesis |
| description | Introduction: Limited evidence on the burden of hepatitis B virus (HBV) infection among children living with HIV (CLWH), HIV-exposed uninfected (HEU) and HIV-unexposed uninfected (HUU) children hinders progress towards eliminating hepatitis B as a public health threat in South Africa. Methods: This study used secondary data and archived sera (N= 671) obtained from children <13 years old presenting at health facilities in the Western Cape, South Africa. Hepatitis B vaccine coverage was assessed using vaccination records for doses 1 to 3 by 12 months of age. Timely uptake of the hepatitis B vaccine was calculated as the difference between the actual and expected date of vaccine receipt, defined as 4 days before and up to 28 days after the recommended age. The prevalence of HBV infection was determined based on the presence of HBsAg within each subgroup. Logistic regression analysis was performed to assess factors influencing incomplete and delayed vaccination. Results: Coverage with all three doses by 12 months of age was 86.7% (13/15), 77.0% (57/74), and 80.9% (263/325) for CLWH, HEU, and HUU, respectively (p=0.645). Hepatitis B vaccine coverage decreased across all subgroups as the dosing schedule progressed from doses 1 to 3. Across the strata, the highest proportion of participants with delayed uptake for the third dose of hepatitis B vaccine was noted among CLWH at 23.1% (3/13), followed by 21.6% (58/269) among HUU and 15.3% (9/59) among HEU children (p= 0.540). The median delay in vaccination for dose 3 was highest among CLWH (11.3 weeks) compared to HUU (6.7 weeks) (p= 0.368). HBV infection was detected in 1.4% (1/74) of HEU and 0.3% (1/328) of HUU children, while no cases were observed among CLWH. Factors associated with completing the three-dose hepatitis B vaccine series included crèche attendance, low-to-middle socio-economic status (SES), timely uptake of dose 1, participant's age (in months), and HIV exposure status. For the third dose, crèche attendance reduced the likelihood of delayed uptake by 69%, while a monthly increase in the participant's age was associated with a 2% increase in delayed uptake in the multivariable model. Conclusion: Our findings highlight disparities in timely hepatitis B vaccine uptake and coverage, emphasizing the need for targeted interventions ensuring timely vaccine uptake among HIV- exposed children. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/43361 |
| institution | University of Cape Town (South Africa) |
| language | English eng |
| last_indexed | 2026-07-01T04:02:30.459Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2026 |
| publishDateRange | 2026 |
| publishDateSort | 2026 |
| publisher | Department of Public Health and Family Medicine |
| publisherStr | Department of Public Health and Family Medicine |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/43361 Hepatitis B virus infection and vaccine coverage among children living with HIV, HIV-exposed uninfected, and HIV-unexposed uninfected children in the Western Cape, South Africa Collins, Courteney Jade Amponsah-Dacosta, Edina Copelyn, Julie children South Africa HIV Cape Town Introduction: Limited evidence on the burden of hepatitis B virus (HBV) infection among children living with HIV (CLWH), HIV-exposed uninfected (HEU) and HIV-unexposed uninfected (HUU) children hinders progress towards eliminating hepatitis B as a public health threat in South Africa. Methods: This study used secondary data and archived sera (N= 671) obtained from children <13 years old presenting at health facilities in the Western Cape, South Africa. Hepatitis B vaccine coverage was assessed using vaccination records for doses 1 to 3 by 12 months of age. Timely uptake of the hepatitis B vaccine was calculated as the difference between the actual and expected date of vaccine receipt, defined as 4 days before and up to 28 days after the recommended age. The prevalence of HBV infection was determined based on the presence of HBsAg within each subgroup. Logistic regression analysis was performed to assess factors influencing incomplete and delayed vaccination. Results: Coverage with all three doses by 12 months of age was 86.7% (13/15), 77.0% (57/74), and 80.9% (263/325) for CLWH, HEU, and HUU, respectively (p=0.645). Hepatitis B vaccine coverage decreased across all subgroups as the dosing schedule progressed from doses 1 to 3. Across the strata, the highest proportion of participants with delayed uptake for the third dose of hepatitis B vaccine was noted among CLWH at 23.1% (3/13), followed by 21.6% (58/269) among HUU and 15.3% (9/59) among HEU children (p= 0.540). The median delay in vaccination for dose 3 was highest among CLWH (11.3 weeks) compared to HUU (6.7 weeks) (p= 0.368). HBV infection was detected in 1.4% (1/74) of HEU and 0.3% (1/328) of HUU children, while no cases were observed among CLWH. Factors associated with completing the three-dose hepatitis B vaccine series included crèche attendance, low-to-middle socio-economic status (SES), timely uptake of dose 1, participant's age (in months), and HIV exposure status. For the third dose, crèche attendance reduced the likelihood of delayed uptake by 69%, while a monthly increase in the participant's age was associated with a 2% increase in delayed uptake in the multivariable model. Conclusion: Our findings highlight disparities in timely hepatitis B vaccine uptake and coverage, emphasizing the need for targeted interventions ensuring timely vaccine uptake among HIV- exposed children. 2026-06-23T11:15:54Z 2026-06-23T11:15:54Z 2026 2026-06-23T10:57:28Z Thesis / Dissertation Masters MPH http://hdl.handle.net/11427/43361 en eng application/pdf Department of Public Health and Family Medicine Faculty of Health Sciences University of Cape Town |
| spellingShingle | children South Africa HIV Cape Town Collins, Courteney Jade Hepatitis B virus infection and vaccine coverage among children living with HIV, HIV-exposed uninfected, and HIV-unexposed uninfected children in the Western Cape, South Africa |
| thesis_degree_str | Master's |
| title | Hepatitis B virus infection and vaccine coverage among children living with HIV, HIV-exposed uninfected, and HIV-unexposed uninfected children in the Western Cape, South Africa |
| title_full | Hepatitis B virus infection and vaccine coverage among children living with HIV, HIV-exposed uninfected, and HIV-unexposed uninfected children in the Western Cape, South Africa |
| title_fullStr | Hepatitis B virus infection and vaccine coverage among children living with HIV, HIV-exposed uninfected, and HIV-unexposed uninfected children in the Western Cape, South Africa |
| title_full_unstemmed | Hepatitis B virus infection and vaccine coverage among children living with HIV, HIV-exposed uninfected, and HIV-unexposed uninfected children in the Western Cape, South Africa |
| title_short | Hepatitis B virus infection and vaccine coverage among children living with HIV, HIV-exposed uninfected, and HIV-unexposed uninfected children in the Western Cape, South Africa |
| title_sort | hepatitis b virus infection and vaccine coverage among children living with hiv hiv exposed uninfected and hiv unexposed uninfected children in the western cape south africa |
| topic | children South Africa HIV Cape Town |
| url | http://hdl.handle.net/11427/43361 |
| work_keys_str_mv | AT collinscourteneyjade hepatitisbvirusinfectionandvaccinecoverageamongchildrenlivingwithhivhivexposeduninfectedandhivunexposeduninfectedchildreninthewesterncapesouthafrica |