Accuracy of HBeAg to identify pregnant women at risk of transmitting hepatitis B virus to their neonates: a systematic review and meta-analysis

Boucheron, Patrick; Lü, Ying; Yoshida, Kyoko; Zhao, Tongtong; Funk, Anna; Lunel‐Fabiani, Françoise; Guingané, Alice Nanelin; Tuaillon, Edouard; Holten, Judith van; Chou, Roger; Bulterys, Marc; Shimakawa, Yusuke

doi:10.1016/s1473-3099(20)30593-4

Cited by 93 publications

(100 citation statements)

References 69 publications

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“…[19] Notably, a recent meta-analysis showed that maternal HBeAg could predict immunoprophylaxis failure in infants with high sensitivity and identify mothers with serum HBV DNA above 5.3 log 10 IU/mL accurately. [20] According to the meta-analysis, WHO recommends that HBeAg testing can be used as an alternative to HBV DNA testing to determine eligibility for tenofovir prophylaxis to prevent mother-to-child transmission of HBV.…”

Section: Introductionmentioning

confidence: 99%

Maternal hepatitis B e antigen can be an indicator for antiviral prophylaxis of perinatal transmission of hepatitis B virus

Lü

Song

Zhai

et al. 2021

Emerging Microbes & Infections

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As a high-risk factor of perinatal HBV transmission, the potential role of maternal hepatitis B e antigen (HBeAg) to guide antiviral prophylaxis has not yet been fully reported. This large prospective cohort study enrolled 1177 hepatitis B surface antigen (HBsAg)-positive pregnant women without antiviral treatment and their newborns. HBeAg, HBsAg, and viral load in maternal serum collected before delivery were measured. All the newborns were given standard passive-active immunoprophylaxis within 12h after birth, and post-vaccination serologic testing was performed at 7 (±7d) months of age. The results revealed that 20 of the 1177 infants (1.70%) were immunoprophylaxis failure, and all their mothers were HBeAg positive. Maternal quantitative HBeAg was positively correlated with viral load (r=0.83; P<0.0001) and quantitative HBsAg (r=0.68; P<0.0001). The area under the receiver operating characteristic curve (AUC) for predicting immunoprophylaxis failure by maternal HBeAg was comparable to that by maternal viral load (0.871 vs 0.893; P=0.441) and HBsAg (0.871 vs 0.871; P=0.965). The optimal cutoff value of maternal quantitative HBeAg to predict perinatal infection was 2.21 log 10 PEI U/mL, and the sensitivity and specificity was 100.0% and 74.5%, respectively. According to maternal viral load >2×10 5 IU/mL, the sensitivity and specificity of maternal qualitative HBeAg to identify the risk of HBV MTCT for pregnant women and determine the necessity for antiviral prophylaxis was 95.5% and 92.6%, respectively. This study showed that maternal HBeAg can be a surrogate marker of HBV DNA for monitoring and evaluating whether antiviral prophylaxis is necessary for preventing perinatal HBV transmission.

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Section: Introductionmentioning

confidence: 99%

Maternal hepatitis B e antigen can be an indicator for antiviral prophylaxis of perinatal transmission of hepatitis B virus

Lü

Song

Zhai

et al. 2021

Emerging Microbes & Infections

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“…Another likely application of DBS HBcrAg is categorizing pregnant women found to carry HBsAg during antenatal care screening for HBV. HBV‐infected women with a viral load of ≥200,000 IU/mL should receive antiviral prophylaxis during the third trimester of pregnancy in order to prevent HBV MTCT 19–21 . Considering the poor availability of RT‐PCR in LMICs where out‐of‐pocket payment for health care is frequent, the use of DBS HBcrAg may render such a strategy to prevent MTCT more realistic.…”

Section: Discussionmentioning

confidence: 99%

Analytical validation of hepatitis B core‐related antigen (HBcrAg) using dried blood spots (DBS)

Shimakawa

Vernoux

Gabassi

et al. 2021

Journal of Viral Hepatitis

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“…The use of HBeAg as a proxy for high HBV DNA viral load has been suggested in settings where HBV DNA measurements are unavailable [ 30 ]. Our data suggest that this approach lacks sensitivity in Ethiopian patients; indeed, less than half of the mothers with HBV DNA viral load above 200,000 IU/mL were HBeAg positive and none of the HBV-infected children had mothers with high HBV DNA viral load.…”

Section: Discussionmentioning

confidence: 99%

Mother-to-Child Transmission of Hepatitis B Virus in Ethiopia

et al. 2021

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High viral load and positive hepatitis B e-antigen (HBeAg) results are risk factors for mother-to-child transmission (MTCT) of hepatitis B virus (HBV). In sub-Saharan Africa, little is known about the distribution of these risk factors, as well as early childhood HBV transmission. In this study, Ethiopian women aged 18–45 years with chronic hepatitis B were assessed for the presence of HBeAg and high viral load. Their children below 4 years of age were invited for assessment of viral markers, defining active HBV infection as a positive hepatitis B s-antigen (HBsAg) and/or detectable HBV DNA. In total, 61 of 428 HBV-infected women (14.3%) had a positive HBeAg result and/or a high viral load. Of note, 26 of 49 women (53.1%) with viral load above 200,000 IU/mL were HBeAg negative. Among 89 children born of HBV-infected mothers (median age 20 months), 9 (10.1%) had evidence of active HBV infection. In conclusion, one in seven women with chronic hepatitis B had risk factors for MTCT, and HBeAg was a poor predictor of high viral load. One in ten children born of HBV-infected women acquired HBV-infection despite completing their scheduled HBV vaccination at 6, 10 and 14 weeks of age.

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Accuracy of HBeAg to identify pregnant women at risk of transmitting hepatitis B virus to their neonates: a systematic review and meta-analysis

Cited by 93 publications

References 69 publications

Maternal hepatitis B e antigen can be an indicator for antiviral prophylaxis of perinatal transmission of hepatitis B virus

Maternal hepatitis B e antigen can be an indicator for antiviral prophylaxis of perinatal transmission of hepatitis B virus

Analytical validation of hepatitis B core‐related antigen (HBcrAg) using dried blood spots (DBS)

Mother-to-Child Transmission of Hepatitis B Virus in Ethiopia

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