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Viral hepatitis type B during pregnancy, the neonatal period, and infancy
Insights
Maternal hepatitis B e antigen presence during pregnancy increases infant chronic HBV infection risk. However, maternal anti-e antibodies may aid in clearing the hepatitis B virus (HBV) infection in newborns.
Area of Science:
- Hepatology
- Virology
- Immunology
Background:
- Hepatitis B virus (HBV) infection poses risks during pregnancy.
- Vertical transmission of HBV from mother to infant is a significant concern.
- The role of specific HBV antigens and antibodies in neonatal infection requires further elucidation.
Purpose of the Study:
- To investigate the correlation between maternal hepatitis B virus (HBV) infection markers and chronic HBV infection in their offspring.
- To determine the influence of maternal HBV e antigen (e Ag) and its antibody (anti-e) on neonatal HBV transmission and chronic infection development.
- To explore factors affecting HBV infection outcomes in infants born to infected mothers.
Main Methods:
- Serological testing for hepatitis B surface antigen (HBsAg), antibody to HBsAg (anti-HBs), antibody to hepatitis B core antigen (anti-HBc), and hepatitis B e antigen (e Ag) and its antibody (anti-e).
- Testing was performed on pregnant women with hepatitis B, chronically infected women, and their infants.
- Correlation analysis was conducted to assess the impact of maternal serological markers on infant HBV infection outcomes.
Main Results:
- Infants born to mothers with hepatitis B e antigen (e Ag) positive status had a higher incidence of chronic HBV infection.
- Maternal anti-HBc titers, HBsAg subtype, cord blood HBsAg presence, infant birth weight, and gestational age did not significantly influence chronic HBV infection.
- Maternal e Ag presence correlated with increased chronic HBV infection in infants; however, e Ag in infants did not show the same severe prognosis as in adults. Maternal anti-e antibodies suggested a potential role in HBsAg clearance.
Conclusions:
- Maternal hepatitis B e antigen (e Ag) is a significant predictor of chronic HBV infection in neonates.
- Infant exposure to e Ag does not appear to carry the same severe prognosis as in adult carriers.
- Maternal anti-e antibodies may play a protective role, potentially aiding in the clearance of HBV infection in newborns.
Abstract:
Eighteen women who developed type B hepatitis late in pregnancy or early in the postpartum period (Groups I and II), 12 women who were chronically infected with the hepatitis B virus (Groups III and IV), and 32 of their offspring were tested for hepatits B surface antigen, antibody to the hepatitis B surface antigen, antibody to the hepatitis B core antigen, and the recently discovered hepatitis B-associated e antigen and its antibody. Twelve of 18 infants born to Group I and Group II mothers and 5 of 14 infants born to Group III and Group IV mothers became chronically infected with HBV: the outcome did not appear to be influenced by maternal anti-HBc titers, by HBsAg subtype, by the presence or absence of HBsAg in the cord sera, or by the infants' birth weights or gestational ages. The presence of maternal e Ag, however, did correlate with the development of chronic HBV infections in the infants studied. The e Ag appeared in five infants born of e Ag-negative mothers but did not appear to be associated with the morbid prognosis which generally accompanies its presence in adult HBsAg carriers. Data also suggest that maternal anti-e may favor HBsAg clearance and recovery in neonatally acquired HBV infections.