Hepatitis B Surface Antigen and Chronic Hepatitis in Infants Born to Asymptomatic Carrier Mothers

Shiraki, Kazuo; Yoshihara, Namiko; Kawana, Takashi; Sakurai, Michiro

doi:10.1001/archpedi.1977.02120190038007

Cited by 24 publications

(4 citation statements)

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“…HBV infection during infancy and childhood is usually clinically asymptomatic with minimal or normal liver histological changes. However, although rare, acute and fulminant hepatitis have been reported in Asian infants born to HBeAg negative carrier mothers …”

Section: Special Populationsmentioning

confidence: 99%

An expert consensus for the management of chronic hepatitis B in Asian Americans

Tong

Pan

Han³

et al. 2018

Aliment Pharmacol Ther

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SummaryBackgroundHepatitis B virus (HBV) infection is common with major clinical consequences. In Asian Americans, the HBsAg carrier rate ranges from 2% to 16% which approximates the rates from their countries of origin. Similarly, HBV is the most important cause of cirrhosis, hepatocellular carcinoma (HCC) and liver related deaths in HBsAg positive Asians worldwide.AimTo generate recommendations for the management of Asian Americans infected with HBV.MethodsThese guidelines are based on relevant data derived from medical reports on HBV from Asian countries as well as from studies in the HBsAg positive Asian Americans. The guidelines herein differ from other recommendations in the treatment of both HBeAg positive and negative chronic hepatitis B (CHB), in the approach to HCC surveillance, and in the management of HBV in pregnant women.ResultsAsian American patients, HBeAg positive or negative, with HBV DNA levels >2000 IU/mL (>104 copies/mL) and ALT values above normal are candidates for anti‐viral therapy. HBeAg negative patients with HBV DNA >2000 IU/mL and normal ALT levels but who have either serum albumin <3.5 g/dL or platelet count <130 000 mm3, basal core promoter (BCP) mutations, or who have first‐degree relatives with HCC should be offered treatment. Patients with cirrhosis and detectable HBV DNA must receive life‐long anti‐viral therapy. Indications for treatment include pregnant women with high viraemia, coinfected patients, and those requiring immunosuppressive therapy. In HBsAg positive patients with risk factors, life‐long surveillance for HCC with alpha‐fetoprotein (AFP) testing and abdominal ultrasound examination at 6‐month intervals is required. In CHB patients receiving HCC treatments, repeat imaging with contrast CT scan or MRI at 3‐month intervals is strongly recommended. These guidelines have been assigned to a Class (reflecting benefit vs. risk) and a Level (assessing strength or certainty) of evidence.ConclusionsApplication of the recommendations made based on a review of the relevant literature and the opinion of a panel of Asian American physicians with expertise in HBV treatment will inform physicians and improve patient outcomes.

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Section: Special Populationsmentioning

confidence: 99%

An expert consensus for the management of chronic hepatitis B in Asian Americans

Tong

Pan

Han³

et al. 2018

Aliment Pharmacol Ther

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“…All these incidents may be related to the fact that human may lose its bacteriostatic capacity during heat treatment (see BRITISH MEDICAL JOURNAL VOLUME 281 20 SEPTEMBER 1980 Viruses Herpes virus, cytomegalovirus, rubella, and hepatitis B have been shown in human milk. [24][25][26] There is no evidence that breast feeding contributes to infants becoming carriers of hepatitis B surface antigen, although this antigen is often found in the milk of carrier mothers. 27 Since there are many alternative prenatal and postnatal routes of transmissions of viruses the role of human milk should not be overestimated, particularly in the light of the antiviral properties of fresh milk (see below).…”

Section: Enterotoxins and Enzymesmentioning

confidence: 99%

Collecting and banking human milk: to heat or not to heat?

Björkstén¹,

Burman²,

Chateau³

et al. 1980

BMJ

131

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Summary and conclusionsData on human breast milk and its handling when fed to babies who cannot be breast-fed were reviewed to determine whether the method of processing and storage affected the properties of the milk. Breast milk is normally contaminated by potential pathogens, which seem to produce no ill effects, but it also contains antimicrobial properties which protect against infection. The evidence suggests that pasteurisation not only eliminates pathogenic bacteria but also damages bacteriostatic mechanisms, so making the milk more susceptible to later contamination. Pasteurisation also affects the nutritional properties of milk. Freezing has little effect on milk proteins, while a study on the effect of refrigeration showed that there was little bacterial growth at temperatures below 8°C. Several years' experience of feeding donated raw milk to newborn infants has confirmed that it produces no ill effects.These findings suggest that pasteurisation of donated breast milk is unnecessary, and it is not recommended, while the decision whether or not to freeze the milk may be made on practical grounds. Raw breast milk can be safely stored at 4-6'C for 72 hours.

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“…Children born to mothers who are positive for hepatitis B surface antigen (HBsAg) and Hepatitis B e antigen (HBeAg) have a 70-90% chance of perinatal acquisition of HBV infection, and over 85-90% of them will eventually become chronic carriers of the disease. Chronic carriers of HBV have an increased lifetime risk of dying from hepatocellular carcinoma and liver cirrhosis (25% risk) [9,10], and remain the main reservoir for continued transmission of HBV [11]. Many of them eventually become mothers themselves, thus perpetuating the cycle [12].…”

Section: Introductionmentioning

confidence: 99%

Prevalence, correlates and pattern of Hepatitis B among antenatal clinic attenders in Yaounde-Cameroon: is perinatal transmission of HBV neglected in Cameroon?

Fomulu

Morfaw

Torimiro

et al. 2013

BMC Pregnancy Childbirth

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BackgroundFew studies have evaluated the prevalence of HBV in the general Cameroonian population or among antenatal attendants. The aim of this study was to determine the prevalence, correlates and patterns of Hepatitis B surface antigen among pregnant women attending antenatal care in Yaounde-Cameroon.MethodsThis was a cross-sectional multicenter study carried out in a referral hospital and two secondary hospitals in Yaounde, the capital of Cameroon. The study lasted 15 months (March 2011 to June 2012), and recruited 959 pregnant women. Patient recruitment was consecutive. The HBsAg was tested using the Monalisa HBsAg Ultra ELISA kit. Other hepatitis B markers were equally tested.We used the statistical package for social sciences (SPSS) version 14.0 software to conduct a quantitative analysis of the derived data. Simple descriptive statistics such as means, standard deviations, and proportions were used to describe the data. We tested for association in categorical variables using the chi-squared (χ2) test. The odds ratio (OR) and the corresponding 95% confidence intervals (95% CI) were used to summarise the strength of association between specific binary exposure and outcome variables. The level of statistical significance for the study was set at p < 0.05.ResultsThe prevalence of hepatitis B infection (HBsAg) among antenatal clinic attenders in our setting was 7.7%. Amongst these women, just 5.4% were previously aware of their HBsAg status. The rate of HBV infectivity was high, with 28% of HBsAg positive women having evidence of HBeAg in their plasma, and up to 45.8% of these women lacking antibodies against hepatitis B e antigen (anti-HBe). About 41% of the pregnant women had had previous contact with HBV as evidenced by the positive status for anti-HBc.Just 2.7% of the pregnant women had previously been vaccinated against HBV. The mean age for HBsAg positivity in our setting was 26.9 ±4.7 years, and the most affected age group was the 25 – 29 years age group. There was no statistically significant association between age or other socio-demographic risk factors and HBsAg status. Numerous risk factors for HBV acquisition exists in our settings, but amongst these, only a history of a contact with hepatitis B infection was found to be significantly associated with HBsAg positivity (OR 1.63, 95% C.I 1.15-2.30). Finally, the coinfection rate of HBV/HIV was 0.74%.ConclusionThe prevalence of hepatitis B among pregnant women in Cameroon is high, and the pattern tends towards high infectivity and therefore increased risk of perinatal HBV transmission. These highlight the need to step up preventive efforts against hepatitis B infection and perinatal HBV transmission in our community.

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Hepatitis B Surface Antigen and Chronic Hepatitis in Infants Born to Asymptomatic Carrier Mothers

Cited by 24 publications

References 10 publications

An expert consensus for the management of chronic hepatitis B in Asian Americans

An expert consensus for the management of chronic hepatitis B in Asian Americans

Collecting and banking human milk: to heat or not to heat?

Prevalence, correlates and pattern of Hepatitis B among antenatal clinic attenders in Yaounde-Cameroon: is perinatal transmission of HBV neglected in Cameroon?

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