https://scholars.lib.ntu.edu.tw/handle/123456789/568467
標題: | Mother-to-infant transmission of hepatitis B virus infection: Significance of maternal viral load and strategies for intervention | 作者: | Wen W.-H. MEI-HWEI CHANG Zhao L.-L. YEN-HSUAN NI HONG-YUAN HSU JIA-FENG WU PEI-JER CHEN Chen D.-S. HUEY-LING CHEN |
公開日期: | 2013 | 出版社: | Elsevier | 卷: | 59 | 期: | 1 | 起(迄)頁: | 24-30 | 來源出版物: | Journal of Hepatology | 摘要: | Background & Aims: Immunoprophylaxis reduces but does not completely eradicate hepatitis B virus (HBV) transmission. This prospective study aims at assessing the rate and risk factors of maternally transmitted HBV infection. Methods: We enrolled 303 mother-infant pairs with positive maternal hepatitis B surface antigen (HBsAg) under current immunization program. Maternal viral load was determined by a real-time PCR-based assay. The children were tested for HBsAg at 4-8 months and/or 1-3 years of age. Rates of HBV infection were estimated using a multivariate logistic regression model. Results: HBeAg-positive mothers (81/303, 26.7%) had higher viral loads than HBeAg-negative mothers (7.4 ± 1.9 vs. 2.7 ± 1.4 log10 copies/ml, p <0.0001). Ten children, born to HBeAg-positive mothers with high viral load (median, 8.4; range, 6.5-9.5 log10 copies/ml), were chronically infected. After adjustment for maternal age, birth type, factors related to maternal-fetal hemorrhage, gestational age, infant gender, birth weight, timeliness of vaccination, and feeding practice, maternal viral load was significantly associated with risk of infection (adjusted odds ratio for each log10 copy/ml increase, 3.49; 95% confidence interval (CI), 1.63-7.48; p = 0.001). The predictive rates of infection at maternal viral load levels of 7, 8, and 9 log10 copies/ml were 6.6% (95% CI, 0.5-12.6%; p = 0.033), 14.6% (95% CI, 5.6-23.6%; p = 0.001), and 27.7% (95% CI, 13.1-42.4%; p <0.001), respectively. Conclusions: Additional strategies to further reduce transmission should be considered in mothers with a viral load above 7-8 log10 copies/ml. ? 2013 European Association for the Study of the Liver. Published. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84984586986&doi=10.1016%2fj.jhep.2013.02.015&partnerID=40&md5=f98646db08297ace6c2b6c52f510798c https://scholars.lib.ntu.edu.tw/handle/123456789/568467 |
ISSN: | 0168-8278 | DOI: | 10.1016/j.jhep.2013.02.015 | SDG/關鍵字: | alanine aminotransferase; h b vax ii; hepatitis B antibody; hepatitis B surface antigen; hepatitis B(e) antigen; maternal antibody; recombinant hepatitis B vaccine; unclassified drug; adult; alanine aminotransferase blood level; article; birth weight; female; follow up; gender; genotype; gestational age; hepatitis B; Hepatitis B virus; human; immunoprophylaxis; infant; infection risk; major clinical study; male; maternal age; microparticle enzyme immunoassay; priority journal; prospective study; risk factor; vaccination; vertical transmission; virus load; virus transmission |
顯示於: | 臨床醫學研究所 |
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