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Perinatal transmission of hepatitis B virus in Thailand
Insights
Hepatitis B virus (HBV) perinatal transmission is linked to HBeAg-positive mothers. Preventive measures are recommended only for infants born to HBeAg-positive mothers carrying the hepatitis B surface antigen (HBsAg).
Area of Science:
- Hepatology
- Virology
- Immunology
Background:
- Hepatitis B virus (HBV) poses a significant risk of perinatal transmission from carrier mothers to infants.
- Asymptomatic mothers carrying the hepatitis B surface antigen (HBsAg) can transmit HBV during childbirth.
- Understanding transmission dynamics is crucial for effective prevention strategies.
Purpose of the Study:
- To investigate the rate and predictors of perinatal HBV transmission from HBsAg-positive mothers to their infants.
- To evaluate the role of hepatitis B e antigen (HBeAg) status in mother-to-child HBV transmission.
- To assess the active immune response to HBV in infants and the impact of hepatitis B immune globulin (HBIG) treatment.
Main Methods:
- Studied 78 mother-infant pairs, monitoring HBsAg, HBeAg, and anti-HBe levels in mothers and infants up to one year of age.
- Assessed anti-HBs levels in 75 non-HBsAg carrier infants, comparing those treated with HBIG at birth to untreated infants.
- Utilized serological markers to determine HBV infection and immune response.
Main Results:
- 32.1% of infants born to HBsAg-positive mothers became HBsAg-positive within 2-6 months and remained positive.
- Perinatal HBV transmission occurred exclusively in infants of HBeAg-positive mothers (92.6%), not in those born to HBeAg-negative mothers.
- Infants born to HBeAg-positive mothers showed a significantly higher active immune response (84.2% anti-HBs positive) compared to those born to HBeAg-negative mothers (14.3%-20.4%).
Conclusions:
- Perinatal HBV transmission is strongly associated with the mother's HBeAg-positive status.
- Targeted preventive interventions should focus on infants born to HBsAg and HBeAg-positive mothers.
- HBeAg-positive mothers' infants exhibit a more robust active immune response to HBV, suggesting potential differences in immune tolerance or exposure levels.
Abstract:
Perinatal transmission of hepatitis B virus (HBV) from asymptomatic HBsAg carrier mothers to their infants was studied in 78 mother-infant pairs by determination of HBsAg, HBeAg and anti-HBe both in the mothers and in their infants at regular intervals for those children up to the time when they reached at least one year of age. Twenty-five out of the 78 (32.1%) infants born to these mothers were HBsAg-positive 2-6 months after birth and they remained so throughout the observation period of at least one year or more. Perinatal HBV transmission occurred only in infants born to HBsAg carrier mothers who were HBeAg-positive (92.6%) but not in those born to HBsAg carrier mothers who had no detectable HBeAg. This study suggests that preventive measures against HBV transmission during the perinatal period should be taken only for infants born to HBsAg carrier mothers who are HBeAg-positive. In addition, the active immune response to HBV was studied in 75 non-HBsAg carrier infants born to HBsAg carrier mothers by determination of anti-HBs at one year of age or older. Forty-three of these infants were treated with HBIG at birth and 32 infants received no treatment. It was found that infants born to HBsAg carrier mothers who were HBeAg-positive had a better active immune response (84.2% positive for anti-HBs) than infants born to HBsAg carrier mothers who had no detectable HBeAg or anti-HBe (14.3% and 20.4% positive for anti-HBs respectively).