The risk factors of transmission after the implementation of the routine immunization among children exposed to HBV infected mothers in a developing area in northwest China

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

“…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.…”

“…Even so, MTCT continues to occur in some infants. A series of recent studies reported the rate of maternally transmitted HBV infection in China to range from 1.54 to 7.29% (6)(7)(8). In order to identify risk factors related to MTCT of HBV, we conducted a retrospective study to carry out a multiple risk factor analysis by collecting clinical and epidemiological data from both mothers and children.…”

A Population-Based Study Examining Hepatitis B Virus Infection and Immunization Rates in Northwest China

“…The OR value of household contact with HBV carriers was 2.6 for the all the participants, 3.8 for 1–14 years of age and 3.0 for the 15–59 years of age, which suggested that this risk factor was more important for children than adults, the OR value was similar with the study of acute hepatitis B in Shanghai[15]. A recent study in Wuwei City indicated that the rate of mother-to-child transmission of HBV was still high (7.3%) and that the absence of HBV vaccination after birth was a possible independent risk factor for increased rates of mother-to-child HBV transmission[19]. Lack of HBV vaccination was the risk factor of HBV chronic infection and exposure to HBV for all the participants.…”

“…After routine implementation of the HBV immunization program in 2002 the primary obstacle to overcome was vaccine administration to children of lower socioeconomic levels, which hampered the efficacy of the vaccination program in infants since some parents did not precisely follow the immunization schedules, especially at younger ages due to low socio-economic status and residence in remote areas that limited access to health and educational services[25], [26]. Besides, the delayed administration of the first HBV vaccine dose to premature infants was a significant risk factor for HBV mother-to-child transmission in individuals living in Wuwei City[19]. Because a high proportion of women of childbearing age (15–49 years of age) remain HBsAg positive (7.2%, CI: 6.0–8.5%) the national program must continue to improve immunization practices if higher levels of vaccination are to be reached.…”

Perinatal hepatitis B prevention program in Shandong Province, China

“…16 A recent study in China showed that delayed HepB birth dose among preterm infants was significantly associated with an increased risk for mother-to-child HBV transmission. 17 Preterm/ low-birth weight infants should receive HepB at birth; for infants <2000 g, the HepB birth dose should not be counted toward the primary series; 3 additional doses (total of 4 doses) are needed for these infants because seroprotection rates after 3 doses can be lower than among term infants with normal birth weight. 3,9,18 In the second half of 2010, province-wide education and training on HepB birth dose in preterm/low birth weight infants was provided for physicians and nurses within obstetrics wards, and the proportion of preterm/low birth weight infants with delayed birth dose decreased in 2011 and 2012.…”