Maternal breast feeding safety of hepatitis B virus carrying parturient women with hepatitis B surface antigen and hepatitis B e antigen double positive / 中华传染病杂志

ABSTRACT

Objective:To explore hepatitis B virus (HBV) infection rate of breast feeding to newborn babies of HBV carrying parturient women with hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) double positive.Methods:A prospective cohort study was conducted to include HBsAg and HBeAg double-positive HBV carrying parturient women and their babies born from February 2016 to May 2018 at the Women′s Hospital, Zhejiang University School of Medicine, and 323 parturient women and 323 babies were enrolled. The babies were divided into breast feeding group and artificial feeding group. Chemiluminescence immunoassay and polymerase chain reaction-fluorescent probe method were used to detect the positive rates of serum HBV markers and HBV DNA levels in the newborns <24 h and seven-month-old age, respectively. The statistical method was performed using χ2 test. Results:A total of 297 parturient women were finally included for the analysis, including 149 in the breast feeding group and 148 in the artificial feeding group. There were no significant differences in the positive rates of HBsAg, hepatitis B surface antibody (anti-HBs), HBeAg and HBV DNA>100 IU/mL between the two groups at birth <24 h and seven months of age (all P>0.05). The positive rate of anti-HBs in newborns in the breast feeding group at birth <24 h was 58.39%(87/149), which was lower than 95.97%(143/149) at seven months of age. The HBeAg-positive group was 65.10%(97/149) at birth <24 h in the breast feeding group, which was higher than 13.42%(20/149) at seven months of age. The differences were both statistically significant ( χ2=59.75 and 40.49, respectively, both P<0.01). The positive rates of HBsAg and HBV DNA>100 IU/mL in newborns in the breast feeding group were 2.01%(3/149) and 2.68%(4/149) at birth <24 h, respectively, and those at seven months were 2.68%(4/149) and 2.68%(4/149), respectively. There were no significant differences between the two time points (both P>0.05). In the artificial feeding group, the positive rate of anti-HBs in newborns was 47.97%(71/148) at birth <24 h, which was lower than 95.94% (142/148) at seven months of age. The positive rate of HBeAg in the artificial feeding group was 55.41%(82/148) in newborns at birth <24 h, which was higher than 19.59%(29/148) at seven months of age. The differences were statistically significant ( χ2=85.37 and 39.84, respectively, both P<0.01). The positive rates of HBsAg and HBV DNA>100 IU/mL in newborns in the artificial feeding group at birth <24 h were 4.73%(7/148) and 1.35%(2/148), respectively, and those at seven months were 1.35%(2/148) and 1.35%(2/148), respectively. There were no significant differences between the two time points (both P>0.05). Conclusions:Breast feeding is not a decisive factor for the risk of vertical transmission in HBsAg and HBeAg double-positive HBV carriers. It is recommended that such women could breastfeed under formal precautions.