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HBsAg carrier infants with serum anti-HBc negativity
1Department of Medicine, Veterans General Hospital, Taipei, Taiwan, Republic of China.
Insights
Hepatitis B vaccination did not prevent vertical transmission in infants born to infected mothers. Some infants with negative anti-hepatitis B core antibody (anti-HBc) showed persistent hepatitis B virus (HBV) infection without liver damage, suggesting immune tolerance.
Area of Science:
- Hepatology
- Immunology
- Pediatrics
Background:
- Hepatitis B virus (HBV) infection poses a significant global health challenge, particularly in vertical transmission from mothers to infants.
- Hepatitis B surface antigen (HBsAg) carrier status in infants born to HBeAg-positive mothers indicates a high risk of chronic infection.
- Understanding the immune response in these infants is crucial for managing HBV infection and preventing liver disease.
Purpose of the Study:
- To investigate the serological and virological profiles of infants born to HBsAg carrier mothers.
- To assess the correlation between anti-hepatitis B core antibody (anti-HBc) status and liver damage in HBsAg carrier infants.
- To explore the implications of anti-HBc negativity in the context of HBV infection and immune response.
Main Methods:
- A cohort of 128 infants born to HBeAg-positive HBsAg carrier mothers were enrolled.
- Serum samples were analyzed for HBsAg, HBeAg, HBV DNA, and anti-HBc.
- Hepatitis B vaccination status was recorded, and follow-up included assessment of serum ALT levels over 3 to 5 years.
Main Results:
- 12 infants (9.4%) were HBsAg, HBeAg, and HBV DNA positive with negative anti-HBc.
- These 12 infants showed normal ALT levels, indicating no significant liver damage.
- In contrast, 39.7% of the 116 anti-HBc-positive HBsAg carrier infants had abnormal ALT levels.
Conclusions:
- HBsAg carrier infants with anti-HBc negativity may represent a state of immune tolerance to HBV antigens.
- Anti-HBc negativity in HBsAg carrier infants is associated with a lack of detectable liver damage.
- These findings suggest that anti-HBc negativity might indicate a distinct immunological profile in vertically infected infants.
Abstract:
A total of 128 HBsAg carrier infants born to HBeAg-positive HBsAg carrier mothers were tested for serum HBsAg, HBeAg, hepatitis B virus DNA and anti-HBc. Ninety-three of them had received hepatitis B vaccination. Anti-HBc had been found to be negative in sera of 12 infants who were HBsAg, HBeAg and hepatitis B virus DNA positive during the follow-up period of 3 to 5 years. Liver damage, as measured by serum ALT levels, was found to be normal among the 12 HBsAg carrier infants with serum anti-HBc negativity, whereas 39.7% of the 116 anti-HBc-positive HBsAg carrier infants had abnormal ALT levels during the follow-up period. Anti-HBe and anti-HBs also were not detected in sera of these anti-HBc-negative HBsAg carrier infants. Thus, HBsAg carrier infants with anti-HBc negativity probably result from immune incompetency of the hepatitis B virus antigens.