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[Vertical hepatitis B transmission by anti-HBe positive hepatitis B carrier mothers]
Insights
Hepatitis B carrier mothers, even those anti-HBe positive, can transmit the virus to their infants, leading to severe or fatal outcomes. All infants born to hepatitis B carrier mothers require immediate passive-active immunization.
Area of Science:
- Virology
- Pediatrics
- Immunology
Background:
- Vertical transmission of Hepatitis B virus (HBV) from mothers to infants is a significant global health concern.
- Hepatitis B surface antigen (HBsAg) carrier mothers are a primary source of HBV infection in newborns.
- The role of anti-HBe positivity in maternal infectivity and infant outcomes requires further elucidation.
Observation:
- Five infants born to healthy, anti-HBe positive, HBsAg carrier mothers were studied.
- Infant infection with HBV manifested between 1 to 6 months post-birth.
- Observed disease courses included subclinical, acute with resolution, fatal fulminant hepatitis B, chronic persistent hepatitis B, and chronic active hepatitis progressing to cirrhosis.
Findings:
- Anti-HBe positive HBsAg carrier mothers can transmit HBV vertically to their infants.
- Infant HBV infection outcomes vary widely, including severe and fatal cases.
- Early signs of infection in infants appeared within the first six months of life.
Implications:
- Infants born to all hepatitis B carrier mothers, regardless of anti-HBe status, are at risk of serious HBV infection.
- Passive-active immunization is crucial for all infants of hepatitis B carrier mothers to prevent vertical transmission and severe disease.
- This highlights the need for universal screening and timely immunization strategies in perinatal HBV prevention.
Abstract:
5 infants (3 boys and 2 girls) were infected vertically with hepatitis B virus by their healthy anti-HBe positive HBsAg carrier mothers. First sign of infection in the infants occurred 1 to 6 months after birth. The course of the disease was as follows: subclinical hepatitis B (1 case), acute hepatitis B with complete resolution (1 case), fatal fulminant hepatitis B (1 case), chronic persistent hepatitis B (1 case), and chronic active hepatitis with rapid progression to cirrhosis. We conclude that anti-HBe positive hepatitis B carrier mothers may be infective and thus may cause serious, eventually fatal disease in their infants. Passive-active immunization must be given to infants of all hepatitis B carrier mothers irrespective if they are anti-HBe positive or not.