Mother‐to‐infant transmission of hepatitis B virus: A Chinese experience

Abstract

Over 90% of infants infected with hepatitis B virus (HBV) caused by mother-to-infant transmission will evolve to carrier status, and this cannot be prevented until widespread administration of the HB vaccine and hepatitis B immune globulin (HBIG) is implemented. This prospective study of 214 infants born to HBsAg-positive mothers was carried out to determine if either perinatal or intrauterine HBV transmission could be effectively prevented with HBIG and the HB vaccine. Peripheral blood was collected from mothers and from newborns before they received HBIG and the HB vaccine, as well as at 0, 1, 7, 24, and 36 months after birth. Infants born with an ratio of signal to noise(S/N) value of >5 for HBsAg (ABBOTT Diagnostic Kit) were defined as mother-to-infant transmission cases, those with an S/N between 5 and 50 were classified as perinatal transmission cases, and those with an S/N >50 were considered intrauterine transmission cases. Mother-to-infant transmission occurred in approximately 4.7% (10/214) of the infants; the perinatal transmission and intrauterine transmission rates were 3.7% (8/214) and 0.9% (2/214), respectively. The risk of mother-to-infant transmission increased along with maternal HBeAg or HBVDNA levels. After 36 months of follow-up, all perinatal cases became HBsAg-negative, whereas all intrauterine transmission cases evolved into carrier status. These results indicate that infants infected via intrauterine transmission cannot be effectively protected by HBIG and HB vaccine.

Influential Factors of Hepatitis B Virus cccDNA in Peripheral Blood Mononuclear Cells Among HBsAg-Positive Pregnant Females Neonates

“…In this study, 7.9% of neonates born to HBsAg-positive mothers showed HBV intrauterine transmission, which was within the range of 5% to 40% in China (17,18).…”

Why are East Asians more susceptible to several infection-associated cancers (carcinomas of the nasopharynx, stomach, liver, adenocarcinoma of the lung, nasal NK/T-cell lymphomas)?

“…Whereas infection during adulthood is frequently cleared, vertical transmission from mother to child leads to persistent infection leading to liver cirrhosis, hepatic decompensation and hepatocellular carcinoma. In a study from China, Shao and colleagues [40] showed that after 36 months of follow-up, all perinatal cases became HBsAg-negative, whereas all intrauterine transmission cases evolved into carrier status. These results indicate that infants infected via intrauterine transmission cannot be effectively protected by HBIG and HB vaccine.…”

Hepatitis B in Pregnancy: Specific Issues and Considerations

“…In a Chinese prospective study of 214 infants born to HBsAg-positive mothers, in which peripheral blood samples were collected from mothers and their newborns prior to receiving HBIG and HBV vaccine, it was found that all cases of perinatal transmission became HBsAg-negative while all cases of intrauterine transmission evolved into the carrier status [65]. The study concluded that infants infected via intrauterine transmission cannot be effectively protected from HBV infection by HBIG and HBV vaccine.…”