Details

Autor(en) / Beteiligte

• Chen, Huey–Ling
• Lin, Lung–Huang
• Hu, Fu–Chang
• Lee, Jian–Te
• Lin, Wen–Terng
• Yang, Yao–Jung
• Huang, Fu–Chen
• Wu, Shu–Fen
• Chen, Solomon Chih–Cheng
• Wen, Wan–Hsin
• Chu, Chia–Hsiang
• Ni, Yen–Hsuan
• Hsu, Hong–Yuan
• Tsai, Pei–Lin
• Chiang, Cheng–Lun
• Shyu, Ming–Kwang
• Lee, Ping–Ing
• Chang, Feng–Yee
• Chang, Mei–Hwei

Titel

Effects of Maternal Screening and Universal Immunization to Prevent Mother-to-Infant Transmission of HBV

Ist Teil von

• Gastroenterology (New York, N.Y. 1943), 2012-04, Vol.142 (4), p.773-781.e2

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2012

Quelle

Access via ScienceDirect (Elsevier)

Beschreibungen/Notizen

• Background & Aims Mother-to-infant transmission is the major cause of hepatitis B virus (HBV) infection among immunized children. There has been much debate about screening pregnant women and administering hepatitis B immunoglobulin (HBIG) to newborns. We analyzed the rate of HBV infection among children born to hepatitis B surface antigen (HBsAg)-positive mothers and whether HBIG administration reduces transmission. Methods We analyzed data from 2356 children born to HBsAg-positive mothers, identified through prenatal maternal screens. In addition to HBV vaccines, HBIG was given to all 583 children with hepatitis B e antigen (HBeAg)-positive mothers and to 723 of 1773 children with HBeAg-negative mothers. Serology tests for HBV were performed from 2007 to 2009, when children were 0.5–10 years old. Results A significantly greater percentage of children with HBeAg-positive mothers tested positive for antibodies against the hepatitis B core protein (16.76%) and HBsAg (9.26%) than children with HBeAg-negative mothers (1.58% and 0.29%, respectively; P < .0001 and <.001). Among the HBV-infected children, the rate of chronicity also was higher among children with HBeAg-positive mothers than children with HBeAg-negative mothers (54% vs 17%; P = .002). Similar rates of antibodies against the hepatitis B core protein (0.99% and 1.88%; P = .19) and HBsAg (0.14% and 0.29%; P = .65) were noted in children born to HBeAg-negative mothers who were or were not given HBIG. Infantile fulminant hepatitis developed in 1 of 1050 children who did not receive HBIG (.095%). Conclusions Children born to HBeAg-positive mothers are at greatest risk for chronic HBV infection (9.26%), despite immunization. Administration of HBIG to infants born to HBeAg-negative mothers did not appear to reduce the rate of chronic HBV infection, but might prevent infantile fulminant hepatitis. Screening pregnant women for HBsAg and HBeAg might control mother-to-infant transmission of HBV.