Brief report. Secular trends of HBeAg prevalence among HBsAg-positive delivery mothers in a hepatitis B endemic area

Abstract

A high prevalence of HBeAg among HBsAg-positive mothers at the time of delivery results in a high prevalence of hepatitis B vertical transmission. From 1990 to 1995, 896 pregnant HBsAg-positive women, including 411 (46 per cent) HBeAg-positive subjects, were enrolled in our study to analyse the secular change in HBeAg prevalence. Their mean age, number of pregnancies and parity were 29.5 +/- 4.1 years, 2.0 +/- 1.2, and 0.6 +/- 0.7, respectively. The prevalence rates of HBeAg were 48, 54, 49, 47, 40, and 40 per cent among the subjects enrolled in 1990, 1991, 1992, 1993, 1994, and 1995, respectively. In univariate analyses, prevalence of HBeAg decreased by the calendar year of pregnancy (p = 0.01), and also by age (p < 0.00001), number of pregnancies (p < 0.0001) and parity (p < 0.0002). After adjusting for age in multiple logistic regression, the calendar year of pregnancy was still the independent variable, while gravida and parity became insignificant. The odd ratios (95 per cent confidence interval) of HBeAg negative-seroconversion in the equations were 1.09 (1.00-1.19) per calendar year and 1.14 (1.10-1.18) per year of age. Our results have shown a secular decrease in HBeAg-prevalence among pregnant HBsAg-positive women in Taiwan.

Changes in the Prevalence of HBsAg and HBeAg: a Study of 8696 Parturients in a Well Vaccinated Area

“…Lu et al . also reported a similar decline with advanced age in the 1990s 10 . In the current study, the HBeAg-positive rate among the HBsAg-positive mothers still declined with increasing age in the past 10 years, and it is encouraging that the prevalence was much lower than in the equivalent group in the 1990s.…”

“…and Lin et al . reported a decrease in the HBeAg-positive rate by year in the 1990s among HBsAg-positive mothers 10, 11 , and a systematic literature review conducted to estimate age- and region-specific HBeAg prevalence rates for females in the Asia Pacific region also showed a remarkable decrease in HBeAg prevalence from 1990 to 2005, and this was even more pronounced among those aged <9 years 20 . In the current study, the HBeAg-positive rate further declined to 22% in the early 2000s, but remained stationary thereafter.…”

“…In contrast, late HBeAg clearance has been associated with the progression of chronic hepatitis and a poor long-term outcome such as liver cirrhosis and HCC 7–9 . Previous studies have reported a decrease in the prevalence of HBeAg among pregnant women in Taiwan during the 1990s 10, 11 ; however, trends in those vaccinated after the introduction of the vaccination program have yet to be reported. Since the vaccinated cohort are now of child-bearing age, we aimed to investigate the effect of the universal HBV vaccination program in Taiwan on this cohort, including the trend of HBeAg prevalence during the 2000s.…”

Role of hepatitis B immunoglobulin in infants born to hepatitis B e antigen-negative carrier mothers in Taiwan

“…11,12 From the economic point of view, the cost of HBIG has declined substantially as Taiwan evolves into a middle or even low endemic area for chronic HBV infection. After 15 years of successful implementation of a universal hepatitis B vaccination program combined with maternal screening in Taiwan, the carrier rates in teenagers have dropped from 15 to 20% to Ͻ2%.…”

“…There was no clear benefit of passive-active vs. active immunization alone for chronic HBV infection in infants of HBsAg-positive, HBeAgnegative mothers. 11,12 According to the present immunization program in Taiwan, 0.5 ml (145 IU) of HBIG is given at birth to those infants whose mothers have HBeAg or reciprocal serum HB-sAg titers of 2560 or more. 1, 2 A combined passive and active immunization program with hepatitis B immunoglobulin (HBIG) and hepatitis B vaccine for infants born to mothers positive for both hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) has proved to be highly effective and safe in preventing perinatal transmission of HBV.…”