Effects of maternal screening and universal immunization to prevent mother-to-infant transmission of HBV
Journal
Gastroenterology
Journal Volume
142
Journal Issue
4
Pages
773-781
Date Issued
2012
Author(s)
Lin L.-H.
Hu F.-C.
Lin W.-T.
Yang Y.-J.
Huang F.-C.
Wu S.-F.
Chen S.C.-C.
Wen W.-H.
Chu C.-H.
Tsai P.-L.
Chiang C.-L.
Chang F.-Y.
Abstract
Background & Aims: Mother-to-infant transmission is the major cause of hepatitis B virus (HBV) infection among immunized children. There has been much debate about screening pregnant women and administering hepatitis B immunoglobulin (HBIG) to newborns. We analyzed the rate of HBV infection among children born to hepatitis B surface antigen (HBsAg)-positive mothers and whether HBIG administration reduces transmission. Methods: We analyzed data from 2356 children born to HBsAg-positive mothers, identified through prenatal maternal screens. In addition to HBV vaccines, HBIG was given to all 583 children with hepatitis B e antigen (HBeAg)-positive mothers and to 723 of 1773 children with HBeAg-negative mothers. Serology tests for HBV were performed from 2007 to 2009, when children were 0.510 years old. Results: A significantly greater percentage of children with HBeAg-positive mothers tested positive for antibodies against the hepatitis B core protein (16.76%) and HBsAg (9.26%) than children with HBeAg-negative mothers (1.58% and 0.29%, respectively; P <.0001 and <.001). Among the HBV-infected children, the rate of chronicity also was higher among children with HBeAg-positive mothers than children with HBeAg-negative mothers (54% vs 17%; P =.002). Similar rates of antibodies against the hepatitis B core protein (0.99% and 1.88%; P =.19) and HBsAg (0.14% and 0.29%; P =.65) were noted in children born to HBeAg-negative mothers who were or were not given HBIG. Infantile fulminant hepatitis developed in 1 of 1050 children who did not receive HBIG (.095%). Conclusions: Children born to HBeAg-positive mothers are at greatest risk for chronic HBV infection (9.26%), despite immunization. Administration of HBIG to infants born to HBeAg-negative mothers did not appear to reduce the rate of chronic HBV infection, but might prevent infantile fulminant hepatitis. Screening pregnant women for HBsAg and HBeAg might control mother-to-infant transmission of HBV. ? 2012 AGA Institute.
SDGs
Other Subjects
hepatitis B antibody; hepatitis B core antibody; hepatitis B surface antibody; hepatitis B surface antigen; hepatitis B vaccine; hepatitis B(e) antigen; article; child; chronicity; controlled study; drug efficacy; female; fulminant hepatic failure; hepatitis B; Hepatitis B virus; human; humoral immunity; immunization; infant; infant disease; infection rate; major clinical study; male; newborn; prenatal screening; preschool child; priority journal; school child; screening test; serology; vertical transmission; virology
Publisher
W.B. Saunders
Type
journal article