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| The efficacy of immune interruptions on blocking mother-to-infant transmission of hepatitis B virus |
| ZHANG Lei1; GUI Xi-En1; CAO Qian1; WU Li-Zhen2; REZIYAN Yi-Si-La-Fu3; ZONG Li-Li4; WANG Xiao-Ping5 |
| 1. Department of Infectious Diseases, Zhongnan Hospital of Wuhan University, Wuhan 430071, China; 2. Maternity and Child Care Centers of Tongcheng County of Hubei Province, Tongcheng 437400, China; 3. Maternity and Child Care Centers of Yining City of Xinjiang Uygur Antonomous Region, Yining 835000, China; 4. Maternity and Child Care Centers of Badong County of Hubei Province, Badong 444300, China; 5. Maternity and Child Care Centers of Xiaonan District of Xiaogan City of Hubei Province, Xiaogan 432100, China |
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Abstract To investigate the efficacy and the roles of immune interruptions on blocking mother-to-infant transmission of hepatitis B virus (HBV) ，667 pregnant women who were seropositive for hepatitis B surface antigen (HBsAg) were enrolled. According to the lab test results of HBeAg and HBV-DNA in the mothers, the mothers were divided into either HBeAg-positive group or HBeAg-negative group, and either HBV-DNA-positive group or HBV-DNA-negative group. Depending on whether the mothers were receiving hepatitis B immunoglobulin (HBIG) once a month during the third trimester of pregnancy, they were divided into either the HBIG-receiving group or the non-HBIG-receiving group. All infants received regular passive and active HBV immunization after birth. Infant serum HBV markers were determined 8-12 months after birth. Twenty infants born to HBsAg-positive mothers were infected with HBV and the failure rate of immune interruptions was 3.0%. The failure rate of immune interruptions in the HBeAg-positive group was 8.7%, which was significantly higher than that observed in HBeAg-negative group 0.2% (P＜0.001). However, the HBV surface antibody (HBsAb) positive rates of the infants between the two groups were not statistically different (P=0.988.) The overall failure rate of immune interruptions of infants born into the HBV-DNA-positive group was 8.1%, and the infants infected with HBV were all born to the mothers whose serum HBV-DNA levels were above 6 log10 copies/ml. There were no statistical differences in the incidence of perinatal HBV infection between mothers receiving HBIG and those not receiving HBIG (3.7% vs 2.7%, P=0.479). No statistical differences were seen in HBsAb positive rates versus vaccination of the infants between the two groups (84.4% vs 82.4%, P=0.519). Among HBeAg-positive pregnant women receiving HBIG, the failure rate of immune interruptions in their infants was 8.4%, compared with 8.9% in those who did not receive HBIG, with no statistical differences (P=0.892). Importantly, 10 out of 11 infants who were infected with HBV were already serum HBsAg-positive immediately after birth, suggesting intrauterine infection either via venous or cord blood. These results indicate that preventative vaccine immunization plus HBIG administration does not block intrauterine transmission of HBV. Approaches to decrease the serum HBV-DNA load in pregnant women by antiviral treatment may efficiently block mother-to-infant transmission.
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Received: 01 April 2011
Published: 01 January 2011
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Corresponding Authors:
GUI Xi-En
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