Discrepancy in impact of maternal milk on vertical transmission between Hepatitis B virus and Human cytomegalovirus

Wang, Ting; Wang, Meiye; Duan, Gehong; Chen, Xiao; He, Yi

doi:10.1016/j.ijid.2015.06.002

Cited by 8 publications

(9 citation statements)

References 25 publications

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“…In infants and children, HBV is largely acquired by VT. If exposed to HBV, neonates have a 90% risk of acquiring chronic HBV infection, whereas adults have a 5–10% chance of developing chronic infection 1,3,6. This vast contrast speaks to the differences in immune response observed in children versus adults.…”

Section: Hbvmentioning

confidence: 99%

“…Although HBV DNA and HBsAg can be detected in breast milk,3,4,9 no study to date has demonstrated a statistically significant increase in VT in infants breastfed by HBV-positive mothers 3,9. Therefore, HBV-positive mothers should not be advised against breastfeeding.…”

Section: Hbvmentioning

confidence: 99%

“…In children, vertical transmission (VT) is the primary route of transmission of viral hepatitis 1–3. Currently, there are limited data available on viral hepatitis in pregnancy and VT. Often, studies are limited by ethical concerns surrounding pregnancy and fetal well-being.…”

Section: Introductionmentioning

confidence: 99%

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Mechanisms and Prevention of Vertical Transmission in Chronic Viral Hepatitis

Mavilia¹,

Wu²

2017

Journal of Clinical and Translational Hepatology

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Vertical transmission (VT) is the primary route of transmission of viral hepatitis in children. The rate of VT ranges from 1–28% with hepatitis B virus (HBV) and 3–15% with hepatitis C virus (HCV). VT for both viruses can occur during the intrauterine or peripartum period. VT of HBV primarily occurs by intrauterine transmission (IUT). Hepatitis B surface antigen is unable to cross the placenta and, therefore, relies on processes like transplacental leakage, placental infection, cellular transmission by peripheral blood mononuclear cells, and germline transmission. HCV can also infect the fetus by IUT. Both viruses also have the potential for transmission during delivery, when there is increase chance of maternal–fetal blood exposure. HBV and HCV share some common risk factors for VT, including maternal viral load, human immunodeficiency virus co-infection and neonatal sex. Prevention of VT differs greatly between HBV and HCV. There are several alternatives for prevention of HBV VT, including antiviral medications during the third trimester of pregnancy and HBV vaccine, as well as hepatitis B immunoglobulin administration to infants post-partum. In contrast, there are no preventative interventions available for HCV. Despite these differences, the key to prevention with both viruses is screening women prior to and during pregnancy.

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Section: Hbvmentioning

confidence: 99%

Section: Hbvmentioning

confidence: 99%

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Mechanisms and Prevention of Vertical Transmission in Chronic Viral Hepatitis

Mavilia¹,

Wu²

2017

Journal of Clinical and Translational Hepatology

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“…35 Clinical and epidemiological studies have shown that individuals getting HBV infection vertically are at a higher risk of developing detrimental complications of the liver and progression towards chronic or in cases HCC. 14,[23][24][25] There is no specific non-invasive biomarker for predicting MTCT of HBV. Moreover, the depressed immune response during pregnancy also plays an important role in manifestation HBV in mother and foetal health during birth.…”

Section: Discussionmentioning

confidence: 99%

Altered expression of endosomal Toll‐like receptors and HBeAg seropositivity may act synergistically towards the vertical transmission of HBV

Kalita

Hazarika

et al. 2023

American J Rep Immunol

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Problem Hepatitis B is one of the leading causes of mortality in India. Despite the mass vaccination programme, the burden of the infection is still increasing due to its vertical transmission. Asymptomatic nature of hepatitis B virus (HBV) infection owing to immune tolerance among pregnant women is a major issue in this regard. Method of study As such, this study aims to investigate the potential role of altered Toll‐like receptor (TLR) expression (TLR‐3, 7 and 9) along with peripheral blood HBeAg status in attaining differential cord blood (CB) HBV DNA status. Result Expression analysis reveals an overall downregulation of expression with mean ± SD value 1.14 ± 1.05, 0.86 ± 0.5 and 0.71 ± 0.4 (TLR 3, 7 and 9, respectively) upon comparison with healthy women. Further stratification based on CB HBV DNA status; the downregulation of expression was found to be significantly (p < .05) associated with positive CB HBV DNA status apart from peripheral HBeAg status. One hundred percent HBeAg positive parturiting women exhibit positive CB HBV DNA. Pearson's correlation analysis reveals a positive correlation between CB HBV DNA status and altered TLR expression, HBeAg status and mother HBV DNA status and as such can be associated with the potential risk of HBV vertical transmission. Conclusion This study suggests that the downregulation of TLR 3, 7 and 9 may be a risk factor for potential vertical transmission of HBV.

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“…Breastfeeding is the most common route of CMV transmission from seropositive mothers to their babies postnatally (1)(2)(3)(4). Most CMV seropositive mothers become reactivated during lactation up to 96% and excrete the virus in breast milk without clinical or laboratory signs of systemic infection (5)(6)(7)(8)(9)(10)(11)(12)(13). CMV transmission rate through breast milk is 58%-69% in term infants, 5.7%-58.6% in preterm infants, and 38% in preterm infants with birth weights of <1,500 g or GA <32 weeks (2,8,14,15).…”

Section: Introductionmentioning

confidence: 99%

Clinical presentation and transmission of postnatal cytomegalovirus infection in preterm infants

et al. 2022

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BackgroundPreterm infants are at greater risk of developing postnatal cytomegalovirus (CMV) infection with serious symptoms. Breast milk is the main route of CMV transmission in populations with a high seroprevalence.ObjectivesThis study aimed to investigate the clinical presentation and transmission of postnatal CMV (pCMV) infection via breast milk in preterm infants under the specific setting of our neonatal intensive care unit (NICU).MethodsThe medical records of 147 preterm infants were reviewed retrospectively, and their clinical characteristics and outcomes were analyzed. Breast milk and infant urine samples were collected every two weeks until discharge, and the kinetics of CMV loads were evaluated using a polymerase chain reaction assay.ResultsSeventeen infants (11.6%) were diagnosed with pCMV infection during the study period. In comparison between the pCMV and control groups, the mean birth weight was significantly lower in the pCMV group than in the control group (1084.1 ± 404.8 g vs. 1362.5 ± 553.8 g, P = 0.047). Four (23.5%) patients had leukocytopenia, six (35.3%) had neutropenia, three (17.6%) had thrombocytopenia, and two (11.8%) had hyperbilirubinemia in the pCMV group. Five patients were treated with antiviral agents, and their CMV load in the urine decreased after treatment. CMV loads peaked at 3–5 weeks in breast milk, whereas they peaked at 8–12 weeks of postnatal age in infants' urine. A comparison between the median CMV load in breast milk from the pCMV and control groups revealed a significant difference (P = 0.043).ConclusionMost preterm infants with pCMV infection present a favorable clinical course and outcomes. A high CMV viral load in breast milk is associated with transmission. Further studies are warranted to prevent transmission and severe pCMV infections in preterm infants.

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Discrepancy in impact of maternal milk on vertical transmission between Hepatitis B virus and Human cytomegalovirus

Cited by 8 publications

References 25 publications

Mechanisms and Prevention of Vertical Transmission in Chronic Viral Hepatitis

Mechanisms and Prevention of Vertical Transmission in Chronic Viral Hepatitis

Altered expression of endosomal Toll‐like receptors and HBeAg seropositivity may act synergistically towards the vertical transmission of HBV

Clinical presentation and transmission of postnatal cytomegalovirus infection in preterm infants

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