Mother-to-infant transmission of hepatitis B virus infection: Significance of maternal viral load and strategies for intervention

Wen, Wan–Hsin; Chang, Mei–Hwei; Zhao, Lulu; Ni, Yen‐Hsuan; Hsu, Hong–Yuan; Wu, Jiafeng; Chen, Pei‐Jer; Chen, Ding‐Shinn; Chen, Huey‐Ling

doi:10.1016/j.jhep.2013.02.015

Cited by 232 publications

(236 citation statements)

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“…In this study, 10 HBV-infected infants were born to HBeAgpositive mothers with a high HBV DNA level, consistent with the results of previous studies (6)(7)(8)(9)(10)(11). For example, Singh et al (9) and Wiseman et al (10) showed that a maternal HBV DNA level of >8 log10 copies/mL is related to immunoprophylaxis failure, while the latest study by Zou et al (6) reported that vaccine breakthrough occurs in infants born to HBeAg-positive mothers with an HBV DNA level above 6 log10 copies/mL.…”

Section: Discussionsupporting

confidence: 91%

“…For example, Singh et al (9) and Wiseman et al (10) showed that a maternal HBV DNA level of >8 log10 copies/mL is related to immunoprophylaxis failure, while the latest study by Zou et al (6) reported that vaccine breakthrough occurs in infants born to HBeAg-positive mothers with an HBV DNA level above 6 log10 copies/mL. The most recent study from Taiwan concluded that pregnant mothers with an HBV DNA titer above 10 7 -10 8 copies/mL should receive additional interventions to reduce the rate of immunoprophylaxis failure (11). In the current study, among the infants born to HBsAg-positive mothers with a pre-delivery HBV DNA level of <6, 6-6.99, 7-7.99 and >8 log10 IU/mL, the corresponding rate of immunoprophylaxis failure was 0%, 6.7% (3/45), 8.6% (6/70) and 7.1% (1/14), respectively.…”

Section: Discussionmentioning

confidence: 99%

“…HBeAg is able to pass through the placenta from mother to fetus, resulting in T-cell tolerance in the uterus (18). Wen et al (11) and Singh et al (9) attributed the role of HBeAg positivity in increasing MTCT to a high maternal viral load. Our findings support this previous work, with the outcome that the HBeAg-positive mothers had significantly higher HBV viral loads than the HBeAg-negative mothers (p<0.0001).…”

Section: Discussionmentioning

confidence: 99%

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Factors Associated with Mother-to-child Transmission of Hepatitis B Virus Despite Immunoprophylaxis

et al. 2015

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Objective This study aimed to assess risk factors for mother-to-child transmission (MTCT) of hepatitis B virus (HBV) after immunoprophylaxis. Methods Risk factors for MTCT were assessed using a multivariate logistic regression model. Patients We enrolled 256 mother-child pairs with positive maternal hepatitis B surface antigens (HBsAg) between January 2010 and June 2013. All children received passive-active immunization after birth. The children were tested for HBsAg at birth and 6-12 months and/or 1-3 years of age. Results Among 256 children, 10 (3.9%) developed HBV infection, all of whom were born to hepatitis B e antigen (HBeAg)-positive mothers with a high HBV DNA level (median, 7.36; range, 6.75-8.00 log10 IU/ mL). A total of 20 mothers received antiviral treatment during pregnancy. The maternal viral load decreased from an average of 7.16 to 3.08 log10 IU/mL (p<0.0001) at delivery. The multivariate logistic regression analysis showed that a high maternal HBV DNA level [odds ratio (OR) for each log10 IU/mL increase, 2.44; 95% confidence interval (CI), 1.13-5.29, p=0.023] and vaginal delivery (OR=6.96, 95% CI, 1.80-26.93, p= 0.005) were risk factors for HBV immunoprophylaxis failure. Conclusion Additional treatment strategies should be considered in HBeAg-positive mothers with an HBV DNA level above 6-7 log10 IU/mL. In addition, our study supports the use of Cesarean section for infants born to HBsAg-positive mothers.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Factors Associated with Mother-to-child Transmission of Hepatitis B Virus Despite Immunoprophylaxis

et al. 2015

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“…Some authors consider that the vertical transmission risk is high when the DNA VHB > 2.105 UI/ml [33]. This transmission risk reaches 28% to 50% for a viral load > 2.108 UI/ml [1] [6].…”

Section: Discussionmentioning

confidence: 99%

Risks of Viral Hepatitis B Transmission in Mother-to-Infant of Pregnant Women Carriers of Chronic Viral Hepatitis B in Cote d’Ivoire

Doffou¹,

Yao²,

Bangoura³

et al. 2017

OJGas

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The aim of this study was to identify the risk factors of mother-to-child transmission of HBV in positive Ag Hbs pregnant women in Cote d'Ivoire. Methods: This was a transversal prospective study that took place over a period of 7 months (from February 2016 to August 2016) in 2 university hospital and 2 private clinics. We consecutively recruited 91 pregnant women who were positive for HBs Ag in prenatal consultations. For each pregnant woman record included in the study, we provided Socio-demographic (Age, marital status, education level, social rank, gravidity, parity) and biological data (HBs Ag, Anti-HBc Total Ac, Hbe Ag, Ac anti-Hbe Ac, DNA-VHB, Ac anti-HCV Ac, retroviral serology, transaminases). All of these data were collected using a survey sheet developed for the study. Results: The age of our pregnant women HBs positive ranged from 18 years to 44 years with a mean age of 30.10 years. The age group from 20 to 39 years was the most represented with a frequency of 92.31%. Almost of all positive HBs Ag pregnant women was HBe Ag negative, only 3.3% was HBe Ag positive. The viral load above 2000 IU/ml was found in 21 (23.03%) patients. There were 4 co-infected patients, which 3 HBV-HIV and 1 HBV-HCV. Only 19 (20.88%) pregnant HBs Ag positive women were able to bring back the supplementary virological assessment within a period less than one month. Conclusion: According to our work the virologic profile of positive HBs Ag in pregnant women in Cote d'Ivoire is characterized by an important viral replication objectified by a high viral load in about 23% pregnant women, a negativity of HBe antigen in 96.6% of them.

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“…In contrast, in children born to HBeAg-negative, HBsAg-seropositive mothers, only 0.29% became HBsAg positive if no HBIG was given at birth, and 0.14% became HBsAg positive if HBIG was given at birth (P ¼ 0.65). The predictive infection rates of vaccinated infants at maternal viral load levels of 7, 8, and 9 log10 copies/mL were 6.6%, 14.6%, and 27.7%, respectively (Wen et al 2013).…”

Section: Vaccine Failurementioning

confidence: 91%

Prevention of Hepatitis B

Chang

Chen

2015

Cold Spring Harbor Perspectives in Medicine

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Hepatitis B virus (HBV) causes life-threatening liver disease. It is transmitted through a horizontal route or a mother-to-infant route, and the latter is the major route in endemic areas. Prevention of HBV infection by immunization is the best way to eliminate HBV-related diseases. The HBV vaccine is the first human vaccine using a viral antigen from infected persons, which is safe and effective. Either passive immunization by hepatitis B immunoglobulin (HBIG) or active immunization by HBV vaccine is effective, and a combination of both yields the best efficacy in preventing HBV infection. The impact of universal HBV immunization is huge, with 90%-95% effectiveness in preventing chronic HBV infection. It is the first cancer preventive vaccine with a protective efficacy against hepatocellular carcinoma (HCC) of 70%. Nevertheless, further effort is still needed to avoid vaccine failure and to increase the global coverage rate.

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Mother-to-infant transmission of hepatitis B virus infection: Significance of maternal viral load and strategies for intervention

Cited by 232 publications

References 36 publications

Factors Associated with Mother-to-child Transmission of Hepatitis B Virus Despite Immunoprophylaxis

Factors Associated with Mother-to-child Transmission of Hepatitis B Virus Despite Immunoprophylaxis

Risks of Viral Hepatitis B Transmission in Mother-to-Infant of Pregnant Women Carriers of Chronic Viral Hepatitis B in Cote d’Ivoire

Prevention of Hepatitis B

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