Viral and bacterial factors of mother‐to‐child transmission of hepatitis B virus

Abstract

Hepatitis B virus (HBV) infection is the tenth leading cause of death worldwide. Mother‐to‐child transmission of HBV occurring mainly at delivery remains one of the most common routes of infection in developing countries. One of the main challenges concerning HBV in Africa is to implement a prevention policy aiming at interrupting the cycle of pseudo‐vertical transmission of this infection. The aim of this study was to assess the implication of certain bacterial and viral factors in mother‐to‐child transmission of HBV. This prospective study was conducted on 165 pregnant women carriers of HBV surface antigen (HBsAg) and their 169 newborns who attended care at the Gynecology Department of the University Hospital of Cocody. Serological, molecular, and bacteriological analyses were performed on blood samples and vaginal secretions. Mean viral load (VL) was 4.5 ± 1.3 log10 IU/ml, while mean HBsAg titres were 3.5 ± 0.9 log10 IU/ml. HBV DNA was found in vaginal secretions in 13.3% of mothers and in the blood of 10.3% of the newborns. Six bacterial species were identified in the vaginal discharge of pregnant women during labour before delivery. Staphylococcus aureus and Enterococcus faecalis were the most frequent species found in 23.0% and 13.9% of cases. Mothers positive for vaginal HBV DNA displayed higher plasma HBV DNA loads than negative mothers (6.2 ± 1.6 log10 IU/ml vs. 4.3 ± 1.0 log10 IU/ml, p < .0001). In conclusion, our study showed that presence of HBV DNA in vaginal secretions and the presence of S. aureus could play a role in mother‐to‐child transmission of HBV. HBV DNA detection in vaginal discharge represents a promising biomarker to identify newborns at risk of perinatal persistent infection.

Association between hepatitis B virus replication during pregnancy and perinatal outcomes: a retrospective cohort study

“…Another study indicated that nearly 30% of women believe that CS is the safest delivery option for the foetus [ 8 ]. It has been previously reported that most mothers believe CS is safer than natural delivery, takes less time, and reduces the risk of HBV transmission during birth [ 10 ]. These beliefs and opinions are assumed to directly influence the choice of the delivery mode.…”

The Association of Hepatitis B Virus Replication During Pregnancy with Perinatal Outcomes: A Retrospective Cohort Study

“…Another study reported that nearly 30% of women believe that a CS is the safest option for the fetus [8]. We previously reported that most mothers believe that CS is safer than natural delivery, shortens the time of delivery, and reduces the risk of neonatal HBV infection during vaginal birth [10]. These beliefs and opinions are considered to directly in uence the mode of delivery.…”

“…Previous studies suggested that the numbers of Lactobacillus in the vagina of pregnant women was negatively correlated with the concentration of pro-in ammatory factors interleukin (IL)-6 and IL-8 [21]. Concurrently, some studies have shown a higher detection rate of HBV DNA in the vagina of patients with active HBV replication than that of the general population [10], and the concentration of IL-6 and IL-8 was also found to be higher than that of the non-HBV infected population [22,23]. Therefore, we hypothesize that active HBV replication may interfere with the normal vaginal environment of pregnant women through pro-in ammatory factors.…”

Hepatocyte proliferation favours viral clearance in young children with chronic hepatitis B virus infection

“…Hepatitis B virus (HBV) infection is a global health problem 1–3 . Vertical transmission of HBV from hepatitis B surface antigen (HBsAg)‐positive mothers to their neonates is the most common cause of HBV infection worldwide 4–6 . Despite passive–active immunoprophylaxis using hepatitis B vaccination with or without hepatitis B immunoglobulin, up to 8%–10% of newborns still acquire HBV infection 7 .…”

“…[1][2][3] Vertical transmission of HBV from hepatitis B surface antigen (HBsAg)-positive mothers to their neonates is the most common cause of HBV infection worldwide. [4][5][6] Despite passive-active immunoprophylaxis using hepatitis B vaccination with or without hepatitis B immunoglobulin, up to 8%-10% of newborns still acquire HBV infection. 7 Managing these children with HBV infection is of paramount importance, which has a direct and significant impact…”