Study on risk factors in trans-placental transmission of hepatitis B virus / 上海预防医学

ABSTRACT

Objective] To study hepatitis B virus ( HBV) mother-to-child transmission and the impact factors, providing the basis for preventive strategies. [ Methods ] A total of 154 hepatitis B surface antigen ( HBsAg ) -positive pregnant women and 297 HBsAg -negative pregnant women from Baoshan District Centers for Disease Control and Prevention in Shanghai were enrolled and received an epidemiological survey regarding mother-to-child transmission.Mothers'peripheral blood and newborns'cord blood were collected to be tested for HBV serological markers and HBV DNA load.HBsAg positivity and HBV DNA≥103 copies/mL in cord blood of newborns born of HBsAg-positive mothers was defined as trans-placental HBV transmission. [ Results] The trans-placental transmission rate was found to be 8.4%for HBsAg-positive mothers.Trans-placental transmission rate was significantly higher among both HBsAg and HBeAg -positive women compared to those only with HBsAg -positiveness ( 20.0% vs. 3.7%, relative risk was 5.41, P <0.05), and increased with HBV DNA load in mothers'peripheral blood. [ Conclusion] HBeAg can directly transmit through the placenta, while HBsAg is“filtered” to a certain degree.HBeAg positiveness and high HBV DNA load of the mother are risk factors in trans-placental transmission, and possibly lead to the failure of newborn immunoprophylaxis.