Effects of maternal screening and universal immunization to prevent mother-to-infant transmission of HBV

Huey Ling Chen, Lung Huang Lin, Fu Chang Hu, Jian Te Lee, Wen Terng Lin, Yao Jung Yang, Fu Chen Huang, Shu Fen Wu, Solomon Chih Cheng Chen, Wan Hsin Wen, Chia Hsiang Chu, Yen Hsuan Ni, Hongyuan Hsu, Pei Lin Tsai, Cheng Lun Chiang, Ming Kwang Shyu, Ping Ing Lee, Feng Yee Chang, Mei Hwei Chang

Research output: Contribution to journalArticlepeer-review

164 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)773-781.e2
JournalGastroenterology
Volume142
Issue number4
DOIs
Publication statusPublished - 2012 Apr

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

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