Author:
Chen Tianyan,Wang Jing,Feng Yuling,Yan Zhi,Zhang Tieying,Liu Minghui,Bai Yun,Song Hongxia,Liu Hongli,Yang Yuan,Liu Jinfeng,He Yingli,Chen Yunru,Zhang Shulin,Zhuang Guihua,Liang Xiaofeng,Liu Zongyin,Xu Xiaguang,Chen Wei,Liu Yong,Zhao Yingren
Abstract
Abstract
Background
Neither HBV DNA nor HBsAg positivity at birth is an accurate marker for HBV infection of infants. No data is available for continuous changes of HBV markers in newborns to HBsAg(+) mothers. This prospective, multi-centers study aims at observing the dynamic changes of HBV markers and exploring an early diagnostic marker for mother-infant infection.
Methods
One hundred forty-eight HBsAg(+) mothers and their newborns were enrolled after mothers signed the informed consent forms. Those infants were received combination immunoprophylaxis (hepatitis B immunoglobulin [HBIG] and hepatitis B vaccine) at birth, and then followed up to 12 months. Venous blood of the infants (0, 1, 7, and 12 months of age) was collected to test for HBV DNA and HBV markers.
Results
Of the 148 infants enrolled in our study, 41 and 24 infants were detected as HBsAg(+) and HBV DNA(+) at birth, respectively. Nine were diagnosed with HBV infection after 7 mo follow-up. Dynamic observation of the HBV markers showed that HBV DNA and HBsAg decreased gradually and eventually sero-converted to negativity in the non-infected infants, whereas in the infected infants, HBV DNA and HBsAg were persistently positive, or higher at the end of follow-up. At 1 mo, the infants with anti-HBs(+), despite positivity for HBsAg or HBV DNA at birth, were resolved after 12 mo follow-up, whereas all the nine infants with anti-HBs(−) were diagnosed with HBV infection. Anti-HBs(−) at 1 mo showed a higher positive likelihood ratio for HBV mother-infant infection than HBV DNA and/or HBsAg at birth.
Conclusions
Negativity for anti-HBs at 1 mo can be considered as a sensitive and early diagnostic indictor for HBV infection in the infants with positive HBV DNA and HBsAg at birth, especially for those infants with low levels of HBV DNA load and HBsAg titer.
Publisher
Springer Science and Business Media LLC
Reference16 articles.
1. Liang X, Bi S, Yang W, Wang L, Cui G, Cui F, Zhang Y, Liu J, Gong X, Chen Y, et al: Epidemiological serosurvey of hepatitis B in China–declining HBV prevalence due to hepatitis B vaccination. Vaccine. 2009, 27: 6550-6557. 10.1016/j.vaccine.2009.08.048.
2. Shao ZJ, Zhang L, Xu JQ, Xu DZ, Men K, Zhang JX, Cui HC, Yan YP: Mother-to-infant transmission of hepatitis B virus: a Chinese experience. J Med Virol. 2011, 83: 791-795. 10.1002/jmv.22043.
3. Hou J, Liu Z, Gu F: Epidemiology and prevention of hepatitis B virus infection. Int J Med Sci. 2005, 2: 50-57.
4. Zhu Q, Yu G, Yu H, Lu Q, Gu X, Dong Z, Zhang X: A randomized control trial on interruption of HBV transmission in uterus. Chin Med J (Engl). 2003, 116: 685-687.
5. Shi Z, Yang Y, Ma L, Li X, Schreiber A: Lamivudine in late pregnancy to interrupt in utero transmission of hepatitis B virus: a systematic review and meta-analysis. Obstet Gynecol. 2010, 116: 147-159. 10.1097/AOG.0b013e3181e45951.
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