Avoidance of Perinatal Transmission of Hepatitis B Virus: Is Passive Immunisation Always Necessary?

Rosendahl, Carla; Kretschmer, Robert; Kochen, MichaelM.; Wegscheider, Karl; Kaiser, D.

doi:10.1016/s0140-6736(83)92866-0

Cited by 29 publications

(10 citation statements)

References 11 publications

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“…Therefore, these patients also carry HBV genomes expressing other escape mutants in their encoded core protein. Interestingly the precore stop codons are less prone to an association with genotype A, due to a possible destabilizing effect of the associated mutation on the stem region of the viral pregenomic encapsidation signal [Li et al, 1993], This is in agreement with the low transmissibility of HBV in North western Europe from healthy HBsAg carrier mothers to their babies [Skinhoj et al, 1972;Rosendahl et al, 1983]. This is the first example of a biologically and clinically important difference associated with a specific HBV ge notype.…”

Section: Im Mune Escape M Utants In Relation To Genotypesmentioning

confidence: 84%

Subtypes, Genotypes and Molecular Epidemiology of the Hepatitis B Virus as Reflected by Sequence Variability of the S-Gene

Magnius

Nordér²

1995

Intervirology

360

294

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The serologic heterogeneity of the hepatitis B virus (HBV) has been established from immunodiffusion experiments for a long time. Four serotypes called subtypes of the hepatitis B surface antigen (HBsAg) have been defined by two mutually exclusive determinant pairs, d/y and w/r, and a common determinant a. These subtypes are adw, ayw, adr and ayr. By subdivision of the four major subtypes in the mid-70s, nine different subtypes were identified. Sequencing of viral genomes has now become a major goal of descriptive virology, and sequence data is now used to trace routes of infection, to reconstruct the phylogenetic history of viruses and two delimit genetic subtypes. A genetic classification based on the comparison of complete genomes has defined four genomic groups of HBV, later referred upon as genotypes, which were designated with A-D. However, the interrelation of the nine subtypes to the genotypes, the possible presence of more than four human HBV genotypes as well as their global geographical prevalence remained to be determined. By sequencing the S-gene of HBV the molecular basis was assessed for the serological variations of HBsAg within the major four subtypes. Thereby, also two new genotypes of HBV designated with E and F were identified. Complete genomic sequencing of E and F strains confirmed their status as new genotypes. The F genotype was found to diverge from other HBV genomes sequenced by 14%, thus being the most divergent HBV genome so far characterized. When the worldwide molecular epidemiology of HBV based on the variability of the S-gene was defined, the E and F strains seemed to originate in aboriginal populations of Africa and the New World, respectively. They shared a unque substitution at residue 140 in the second immunodominant loop of their encoded surface antigen when compared to the vaccine strain. Future research will establish whether this substitution may predispose to a vaccine escape mutant at residue 141, that now has been reported to occur in conjunction with the 140 substitution.

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Section: Im Mune Escape M Utants In Relation To Genotypesmentioning

confidence: 84%

Subtypes, Genotypes and Molecular Epidemiology of the Hepatitis B Virus as Reflected by Sequence Variability of the S-Gene

Magnius

Nordér²

1995

Intervirology

360

294

View full text Add to dashboard Cite

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“…Only the HBsAg particle may be transmitted rather than the whole virus. 20 Hepatitis B e antigen is also easily transmitted via the placenta because it is smaller than HBsAg and is not agglutinated. 20 Our observation of isolated HBe antigenemia in seven cord blood samples also indicates this possibility.…”

Section: Discussionmentioning

confidence: 99%

“…20 Hepatitis B e antigen is also easily transmitted via the placenta because it is smaller than HBsAg and is not agglutinated. 20 Our observation of isolated HBe antigenemia in seven cord blood samples also indicates this possibility. Alternatively, antigenemia in cord samples may result from contamination by maternal blood at delivery.…”

Section: Discussionmentioning

confidence: 99%

Detection of hepatitis B surface antigen in pregnant women attending a public hospital for delivery: implication for vaccination strategy in Bangladesh.

Rumi¹,

Begum²,

Hassan³

et al. 1998

The American Journal of Tropical Medicine and Hygiene

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Routine antenatal hepatitis B surface antigen (HBsAg) screening and immunization of risk babies is very effective in preventing perinatal transmission of hepatitis B virus (HBV). We studied 1,800 parturients attending a public hospital to assess the rationale for such vaccination in Bangladesh. In one in every 29 deliveries (63 of 1,800 or 3.5%), the mother was found to be HBsAg positive. All were asymptomatic and many (41 of 63 or 65%) without risk factors would remain undetected if HBsAg screening were performed on selected groups. Most of the HBsAgpositive mothers (54 of 63 or 85.7%) were found to be chronic carriers and 30.2% (19 of 63) were also hepatitis B e antigen (HBeAg) positive, indicating high infectivity. Although 23 cord blood were positive for HBsAg or HBeAg, none were positive for IgM antibody to hepatitis B core antigen (IgM anti-HBc), suggesting transplacental transmission of the antigens rather than intrauterine infection. These findings are discussed in relation to the cost-effectiveness of routine prenatal screening and immunization of risk babies compared with universal infant immunization.

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“…Among mothers who are positive for HBeAg, the risk of transmitting HBV to their infants is 80 to 90% and 80 to 90% of those infants will become chronic carriers 9 – 13 ) . The frequency of HBeAg in chronic hepatitis B is about 40 % in this country 14 ) in contrast to the less than 4% in North America and Northern Europe 15 ) . Vertical transmission accounts for 20 to 40% of the world’s carriers (50 million) 2 , 16 – 18 ) .…”

Section: Introductionmentioning

confidence: 82%

Hepatitis B Viral Markers In Pregnant Women and Newborn Infants in Korea

Ryoo¹,

Chang²,

Choi³

et al. 1987

Korean J Intern Med

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A study of the 5,284 pregnant women who delivered at St. Columban’s Hospital in Mokpo City between April 1, 1985 to June 30, 1987 was conducted to determine the presence of hepatitis B viral (HBV) markers in the mothers and infants and to evaluate their effects. Medical histories, physical examinations, liver function studies and the ELISA test for HBV markers were reviewed.The following results were obtained: Of the 5,284 pregnant women, 448 (8.48%) were positive for HBsAg. Three hundred and thirty four women tested positive for HBsAg; 130 (38.92%) were HBeAg positive, 105 (31.44%) were HBeAg and anti-HBe negative, and 99 (29.64%) were anti-HBe positive.Women positive for HBsAg exhibited a slight increase in toxemia (p<0.1), and no significant difference in postpartum hemorrhage (0.05< p <0.1) and the severity of hyper-emesis.SGPT was significantly higher in HBeAg positive women than in HBeAg negative women (p<0.01), and it was significantly more elevated in both eclamptic and preeclamptic women than in normal pregnant women (p<0.005).The frequency of congenital malformation, spontaneous abortion, infantile death and physiologic jaundice was increased in the newborns of chronic HBV carriers, while women with active hepatitis B experienced more premature births.Mother to infant transmission of HBsAg and HBeAg was high in the HBeAg positive group (18.0%, 42.7%) respectively, but very low in the HBeAg negative group (7.8%, 0.0%). Mother to infant transmission of antibodies was in the order of anti-HBc (95.5%), anti-HBe (91.2%) and anti-HBs (75.0%).The effects of the HBV carrier state in pregnant women included increases in toxemia, postpartum hemorrhage, congenital malformations and premature births, however none of them were statistically significant.There was a significant difference in the elevation of SGPT between toxemic and normal pregnant women, and between HBeAg positive and HBeAg negative carrier women.The mother to infant transmission rate of HBeAg was more frequent than that of HBsAg.

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Avoidance of Perinatal Transmission of Hepatitis B Virus: Is Passive Immunisation Always Necessary?

Cited by 29 publications

References 11 publications

Subtypes, Genotypes and Molecular Epidemiology of the Hepatitis B Virus as Reflected by Sequence Variability of the S-Gene

Subtypes, Genotypes and Molecular Epidemiology of the Hepatitis B Virus as Reflected by Sequence Variability of the S-Gene

Detection of hepatitis B surface antigen in pregnant women attending a public hospital for delivery: implication for vaccination strategy in Bangladesh.

Hepatitis B Viral Markers In Pregnant Women and Newborn Infants in Korea

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