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Hepatitis B surface antigen and chronic hepatitis in infants born to asymptomatic carrier mothers
Insights
Hepatitis B vertical transmission is common in infants born to asymptomatic mothers carrying hepatitis B surface antigen (HBsAg). Some infants develop chronic hepatitis B, highlighting the need for early detection and intervention.
Area of Science:
- Hepatology
- Virology
- Pediatrics
Background:
- Hepatitis B virus (HBV) infection poses a significant global health challenge.
- Vertical transmission from mother to infant is a primary route of HBV spread.
- Asymptomatic carriers of hepatitis B surface antigen (HBsAg) can unknowingly transmit the virus.
Purpose of the Study:
- To investigate the rate and implications of vertical hepatitis B virus transmission.
- To identify risk factors for infant HBV infection in carrier mothers.
- To assess the long-term outcomes of infants born to HBsAg-positive mothers.
Main Methods:
- Prospective follow-up of 23 infants born to HBsAg-positive mothers.
- Monitoring for HBsAg positivity, hepatic dysfunction, and antibody to HBsAg (anti-HBs).
- Radioimmunoassay used to detect HBsAg in breast milk.
Main Results:
- Four infants tested positive for HBsAg within four months.
- Three infants exhibited hepatic dysfunction, with one diagnosed with mild chronic hepatitis and another with persistent hepatitis.
- HBsAg in cord blood was a strong predictor of infant infection.
- HBsAg detected in breast milk in three cases.
- Six infants developed anti-HBs without antigenemia after six months.
Conclusions:
- Vertical transmission of HBV is frequent in infants of asymptomatic HBsAg carrier mothers.
- Infants can become persistent carriers or develop chronic hepatitis, often without overt symptoms.
- Early detection of HBsAg in cord blood and consideration of breast milk transmission are crucial.
Abstract:
Twenty-three infants born to asymptomatic hepatitis B surface antigen (HBSAg) carrier mothers were followed up to determine the vertical transmission of hepatitis B virus. Four infants became positive for HBSAg within four months after birth. Three showed hepatic dysfunction; liver biopsy specimens demonstrated mild chronic hepatitis in one and persistent hepatitis in another. In six infants followed up for more than six months after birth, antibody to HBSAg (anti-HBS) without antigenemia could be detected. Antigenemia of cord blood strongly suggested that hepatitis B viral infection of the infant would occur. HBSAg was also demonstrated in breast milk by radioimmunoassay in three cases. These findings indicate that vertical transmission of hepatitis B virus occurs in many infants born to asymptomatic HBSAg carrier mothers, and that some of them become persistent carriers or develop chronic hepatitis without showing any signs suggesting hepatic involvement.