Reduced mother-to-child transmission of hepatitis B after implementation of completely charge-free active-passive immunoprophylaxis: an observational cohort study

Elimination of hepatitis B virus infection in children: experience and challenge in China

“…In 2002–2004, 16–18 years after the availability of hepatitis B vaccine produced in China, HBsAg prevalence in 6398 pregnant women at the second trimester across Jiangsu province was reduced to 6.7% [58] . From July 2011 to June 2016, the average HBsAg prevalence based on the pregnancy population from two county-level cities and one county in south, middle, and north Jiangsu, respectively, was 5.2% (1814/34,614), 5.5% (3397/62,053), and 5.7% (3393/59,296), respectively [14] . In Rugao city, in the middle of Jiangsu, the HBsAg prevalence in all pregnant women tended to decline over time, from 6.4% (414/6449) in 2011 to 4.9% (281/5760) in 2016 [59] .…”

“…When the recommended passive-active immunoprophylaxis has adhered, the immunoprophylaxis failure almost all occurs in infants born to carrier mothers with HBV DNA levels >2 × 10 6 (6.3) log 10 U/mL [14,18,19–21] or with positive HBeAg [22–26] . Studies revealed that pregnant women with positive HBeAg have median HBV DNA levels as high as 7.3–8.1 log 10 U/mL [27–30] .…”

“…A cross-sectional analysis of real-world data in four representative provinces, Guangdong, Zhejiang, Shaanxi, and Hebei, conducted between October 2017 and January 2018, showed that, of 4112 infants (2818 [68.5%] from rural areas) of HBsAg-positive mothers born between April 2016 and March 2017, only 35 (0.9%) were infected with HBV [15] . The results of a real-world data analysis based on 5149 children of HBsAg-positive mothers in Jiangsu province found that before July 2011, MTCT in children of carrier mothers with positive HBeAg was 10.3% (19/185), whereas MTCT was reduced to 5.8% (73/1248) since July 2011 [14] . These data demonstrate that the nationwide program of completely charge-free HBIG and hepatitis B vaccine in all newborn infants of HBsAg-positive mothers has greatly improved the efficacy of immunoprophylaxis against MTCT of HBV, and the efficiency of immunoprophylaxis is comparable to that in advanced countries or regions [19,53,54,57] …”

“…[58] From July 2011 to June 2016, the average HBsAg prevalence based on the pregnancy population from two county-level cities and one county in south, middle, and north Jiangsu, respectively, was 5.2% (1814/34,614), 5.5% (3397/62,053), and 5.7% (3393/59,296), respectively. [14] In Rugao city, in the middle of Jiangsu, the HBsAg prevalence in all pregnant women tended to decline over time, from 6.4% (414/6449) in 2011 to 4.9% (281/5760) in 2016. [59] As the HBsAg prevalence in teenagers and young adults at 15-29 years of age in 2014 was 4.4% (409/9294), [42] it is predictable that the HBsAg prevalence in pregnant women will continuously decline in the coming years.…”

“…HBIG should be stored in delivery rooms to ensure its immediate use. Additionally, more efforts should be taken to ensure that all pregnant Yin et al [22] Liaoning, Northeast China 82 0 167 12 (7.2) Ding et al [23] Hubei and Xinjiang, Central and Northwest China 647 0 367 29 (7.9) Zhang et al [24] Jiangsu, East China 126 0 49 4 (8.2) Evans et al [25] Hubei, Central China 996 0 223 11 (4.9) Peng et al [26] Jiangsu, East China 2741 0 1248 73 (5.8) Xu et al [14] Chen et al [56] women are screened for HBsAg in the first or second trimester.…”