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ObjectiveTo investigate the hepatitis B virus (HBV) infection rate among pregnant women in Shaanxi Province, China and the high-risk population of mother-to-infant transmission (MTIT). MethodsA survey was performed for 13 451 pregnant women in 18 hospitals in Shaanxi Province to investigate the status of HBV infection, and combined immunization was performed for the infants born to HBsAg-positive women. Univariate and multivariate logistic regression analyses were used to investigate the risk factors for MTIT. The t-test or the Mann-Whitney U test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups. ResultsThe prevalence rate of HBsAg was 7.07% among the pregnant women in Shaanxi Province, and the rate reached as high as 9.40% in southern Shaanxi. The MTIT rate of HBV was 5.21%. The univariate analysis showed that HBsAg titer, HBeAg titer, positive HBeAg, and HBV DNA load in mothers were associated with HBV infection in infants, and the multivariate analysis showed that HBV DNA load in mothers is an independent risk factor for MTIT (relative risk=1.586, 95% confidence interval: 1.020-2.465, P=0.041). Among the pregnant women with HBV infection and MTIT, 84.62% had positive HBeAg and an HBV DNA load of ＞106 IU/ml; among the infants with MTIT, 15.38% were the infants born to the HBeAg-negative pregnant women. For the pregnant women with positive HBeAg and HBV DNA＞106 IU/ml, the relative risk of MTIT in infants was 1.210 (1.129-1.297); for the pregnant women with negative HBeAg, HBV DNA＞2×103 IU/ml, and HBsAg ＞104 IU/ml, the relative risk of MTIT in infants was 26.062 (2.633-258024). ConclusionThere is a high HBV infection rate among pregnant women in Shaanxi Province. Pregnant women with positive HBeAg and a high HBV DNA load have a high risk of MTIT. Although the infants born to HBeAg-negative mothers have a low HBV infection rate, there is still a high risk of MTIT when the mother has an HBV DNA load of ＞2×103 IU/ml and an HBsAg level of ＞104 IU/ml.
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<p><b>OBJECTIVE</b>To determine the hepatitis B immunoprophylactic failure rate in infants born to hepatitis B virus (HBV) infected mothers and to characterize HBV genes.</p><p><b>METHODS</b>HBV-serological testing was conducted for pregnant women and infants. The complete genomes of 30 HBV isolates were sequenced, and genetic characteristics were analyzed using MEGA 5 software.</p><p><b>RESULTS</b>The immunoprophylactic failure rate for infants who had completed the scheduled hepatitis B vaccination program was 5.76% (32/556). High sequence homology (99.8%-100%) was observed in 8 of the 10 mother-infant pairs. We identified 19 subgenotype C2 strains, 9 subgenotype B2 strains, and 2 subgenotype C1 strains. Three serotypes were detected: adr (19/30), adw (9/30), and ayw (2/30). The frequency of amino acid mutation of the 'a' determinant region was 16.67% (5/30), including that of Q129H, F134Y, S136Y, and G145E. We detected 67 amino acid mutations in the basal core promoter, precore, and core regions of the genome.</p><p><b>CONCLUSION</b>The immunoprophylactic failure rate in infants born to HBV-infected mothers is low in the regions of China examined during this study. Moreover, HBV mutation in the 'a' determinant region could not account for immunoprophylactic failure for all infants.</p>
Subject(s)
Adult , Animals , Cricetinae , Female , Humans , Infant, Newborn , Pregnancy , Young Adult , CHO Cells , China , Epidemiology , Cricetulus , Hepatitis B , Epidemiology , Hepatitis B Vaccines , Therapeutic Uses , Hepatitis B virus , Genetics , Infectious Disease Transmission, Vertical , Mutation , Phylogeny , Treatment FailureABSTRACT
OBJECTIVE: To evaluate the efficacy and safety of telbivudine in preventing mother-to-infant HBV transmission in pregnant women who have positive HBsAg and HBeAg during the third trimester of pregnancy. METHODS: A total of 80 pregnant women, who had positive HBsAg and HBeAg with HBV DNA levels of ≥1 × 106 copies · mL-1 were divided into two groups: the treatment group and the control group. Each group comprised 40 cases. The subjects in the treatment group received telbivudine 600 mg once daily from the 28th weeks of pregnancy till delivery. The subjects in the control group did not receive telbivudine or other anti-virus drugs. The adverse reactions of the subjects in the treatment group were observed, and the serum HBV DNA levels in the two groups were measured at the 28th weeks of pregnancy, upon delivery and 6 months after delivery, respectively. The infants in the two groups received IM HBIG 200 IU immediately after birth and 1 month after birth. And both of the groups received IM hepatitis B vaccine 10 μg immediately after birth as well as 1 month and 6 months after birth. The serum HBsAg and HBV DNA levels in all infants were measured at birth, 6 months, and 12 months after birth, respectively. RESULTS: There was no significant difference in serum HBV DNA levels between the treatment group and the control group at the 28th weeks of pregnancy. The serum HBV DNA level immediately after delivery in the treatment group [(3.48±0.90) × 10 copies · mL-1] was significantly decreased compared with the control group [(6.96±0.94) × 10 copies · mL-1](P<0.05). There was no significant difference in HBV DNA levels between the treatment group and the control group 6 months after delivery. The rates of mother-to-infant HBV transmission in 12-month-old infants in the treatment group and the control group were 97.5% and 75%, respectively. The difference was statistically significant(P<0.05). No adverse reaction was found in the treatment group, and abnormal development was not found in the infants of the two groups. CONCLUSION: Telbivudine appears to be effective and safe in preventing HBV mother-to-infant transmission and has no influence on infant development.
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This study was undertaken to investigate mother-to-infant transmission of human parvovirus B19 and the significance of prevalence of B19 virus in abnormal fetuses in Guandong. The polymerase chain reaction (PCR)was established to detect parvovirus B19 DNA in 700 sera from 350 maternal-infant pair groups. The prevalence of B19 virus DNA was 1.14％ (4/350)and 0.28％(1/350)in the sera of pregnant women and cord blood of their neonates respectively. Parvovirus B19 DNA sequences were also detected in abnormal fetuses and new-born by PCR. The positive results were obtained in 5 samples of fetal tissues from 17 abnormal fetuses and in 3 those of neonatal tissues from 7 cases of neonatal death. The amplified products of PCR were identified to be the target DNA with Hae Ⅲ digestion. By in situ hybridization ,parvovirus DNA could be detected mainly in the nuclei of immature hematopoetic cells within fetal brain or spleen whose PCR tests were positive. The study results suggest that human parvovirus B19 infection does exist in maternal-infant transmission in Guangdong and might lead to harm on fetuses,but the prevalence rate of B19 virus may be very low. The evaluation of B19 virus infection might depend on reliable assay to determine present infection or past infection.
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Objective: To invistigate the characteristics of mutations in EnhII/CP/PreC of HBV in AsC children infected through mother-to-infant transmission and their AsC mothers with different degrees of viremia.Methods: There were 15 pairs of children and mothers.They were divided into three groups based on the level of viremia: groupⅠ(both children and mothers presented high viremia),groupⅡ(children presented high and mothers presented low viremia) and groupⅢ(children presented low and mothers were high viremia).There were 5 pairs in each group with 4/5 of HBV being B/adw2 and 1/5 of HBV being C/adrq+ in each group.EnhII/CP/PreC was amplified and cloned into pGEM-T vector.Tow clones were selected to sequence each patient.Results: Substitution was the main model of mutations.There were no significant differences in the mutation numbers in EnhII/CP/PreC among high viremia groups or between two low viremia groups.There were significant differences between each high viremia group and each low viremia group.In patients with high viremia,there were 6 mutational positions in 32 clones in 16/20 patients with B/adw2,and there were 4 mutational positions in 8 clones in 4/20 patients with C/adrq+.In patients with low viremia(mothers of group Ⅱ and children of group Ⅲ),there were 26 mutational positions totally.Conclusion: The mutations in EnhII/CP/PreC are related to the degree of viremia in AsC children infected through mother-to-infant transmission and their AsC mothers,and no associated with age.