Untreated highly viraemic pregnant women from Asia or sub-Saharan Africa often transmit hepatitis B virus despite serovaccination to newborns
- 3 April 2014
- journal article
- viral hepatitis
- Published by Wiley in Liver International
- Vol. 35 (2), 409-416
- https://doi.org/10.1111/liv.12561
Abstract
Background & Aims Mother‐to‐child (MTC) hepatitis B virus (HBV) transmission has been mainly studied in Asia. The geographical origins of women and HBV genotypes differ in Europe. The aims were to determine the rate and risk factors of MTC HBV transmission from women with high HBV DNA loads in a maternity hospital in Paris, France. Methods Retrospective study of HIV‐negative, HBs Ag‐positive pregnant women with HBV DNA loads above 5 Log10 I.U/ml who were not given lamivudine or tenofovirDF during pregnancy between 2004 and 2011. Results Among 11 417 pregnant women, 437 (4%) showed a positive HBs Ag. Among these women, 52 had HBV DNA loads above 5 Log10 I.U/ml: 41, 10 and 1 born in Asia, sub‐Saharan Africa and Europe respectively. Among the 52 women, 40 were eligible for the analysis: no antiviral therapy during pregnancy; children over 9 months old. Twenty‐eight (70%) women were assessed, corresponding to 41 childbirths. Eleven children (27%) had positive HBs Ag, 14 (34%) had positive HBc and HBs Ab, 16 (39%) had positive HBs Ab only. The risk of having positive HBs Ag, according to maternal HBV DNA loads, was 14% for HBV DNA loads less or equal to 8 Log10 I.U/ml, 42% for HBV DNA loads over 8 Log10 I.U/ml, P = 0.04, but not related to the women's origin, HBV genotype. Conclusions This study confirms that serovaccination does not fully protect newborns from MTC HBV transmission, when maternal HBV DNA loads exceed 5 Log10 I.U/ml, regardless of the women's origin or HBV genotype.Keywords
This publication has 19 references indexed in Scilit:
- An Algorithm for Risk Assessment and Intervention of Mother to Child Transmission of Hepatitis B VirusClinical Gastroenterology and Hepatology, 2012
- Liver disease in pregnancyThe Lancet, 2010
- Hepatitis B and pregnancy: an underestimated issueLiver International, 2009
- MEGA4: Molecular Evolutionary Genetics Analysis (MEGA) Software Version 4.0Molecular Biology and Evolution, 2007
- Management of hepatitis B: Summary of a clinical research workshopHepatology, 2007
- Chronic hepatitis BHepatology, 2007
- Antepartum immunoprophylaxis of three doses of hepatitis B immunoglobulin is not effective: a single‐centre randomized studyJournal of Viral Hepatitis, 2006
- Hepatitis B Virus DNA during Pregnancy and Post Partum: Aspects on Vertical TransmissionScandinavian Journal of Infectious Diseases, 2003
- Risk factors and mechanism of transplacental transmission of hepatitis B virus: A case‐control studyJournal of Medical Virology, 2002
- Outcome Of Perinatal Hepatitis B Virus Exposure Is Dependent On Maternal Virus LoadThe Journal of Infectious Diseases, 1994