Measures to reduce mother-to-child transmission of Hepatitis B virus in China: a meta-analysis.

Abstract

BACKGROUND:

Mother-to-child transmission (MTCT) is the main mode of spread of hepatitis B virus (HBV) in China. We performed a meta-analysis to compare the effects of three measures for prevention of MTCT.

METHODS:

A meta-analysis was performed on randomized controlled trials and non-randomized studies comparing the index of MTCT among five groups of pregnant women: hepatitis B immunoglobulin (HBIG) administration, antiviral treatment, placebo, elective caesarean section, and vaginal delivery.

RESULTS:

Compared with the control group, the incidence of HBV intrauterine infection (RR = 0.42, 95 % CI 0.27-0.64, P < 0.0001) and the number of chronic hepatitis B (CHB) infants (RR = 0.44, 95 % CI 0.32-0.61, P < 0.00001) were lower in the HBIG administration group. In the antiviral treatment group, serum HBV DNA levels were lower (MD = -4.01, 95 % CI -5.07 to -2.94, P < 0.00001) at the time of delivery, and normalization of ALT levels was better (RR = 1.11, 95 % CI 1.06-1.17, P < 0.0001). Infant serum HBsAg positivity (RR = 0.45, 95 % CI 0.22-0.91, P = 0.03) and incidence of infant HBV transmission RR = 0.06, 95 % CI 0.01-0.24, P < 0.0001) were reduced in antiviral the treatment group. Infant serum anti-HBs positivity at birth (RR = 1.24, 95 % CI 0.89-1.74, P = 0.2) or at 6-7 months (RR = 0.98, 95 % CI 0.86-1.11, P = 0.73) was not significantly different between the caesarean section and vaginal delivery groups. The incidence of infant CHB infection may have been higher in the vaginal delivery group (RR = 2.20, 95 % CI 1.02-4.74, P = 0.04).

CONCLUSIONS:

Administration of HBIG or antiviral therapy to HBV carrier mothers during pregnancy is effective in reducing MTCT.

• Authors: Hua Xu, Teng Zeng, Jun-Ying Liu, Yu Lei, Shan Zhong, Yun-Jian Sheng, Zhi Zhou, Hong Ren
• Journal: Digestive diseases and sciences (Dig Dis Sci) Vol. 59 Issue 2 Pg. 242-58 (Feb 2014) ISSN: 1573-2568 [Electronic] United States
• PMID: 24193353 (Publication Type: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't, Review)

Chemical References

• Antiviral Agents
• Hepatitis B Vaccines
• Immunoglobulins
• hepatitis B hyperimmune globulin

Topics

• Adult
• Antiviral Agents (therapeutic use)
• Cesarean Section
• Chi-Square Distribution
• China (epidemiology)
• Elective Surgical Procedures
• Female
• Hepatitis B Vaccines (therapeutic use)
• Hepatitis B, Chronic (diagnosis, epidemiology, prevention & control, transmission)
• Humans
• Immunoglobulins (therapeutic use)
• Incidence
• Infant, Newborn
• Infectious Disease Transmission, Vertical (prevention & control)
• Odds Ratio
• Pregnancy
• Risk Factors
• Treatment Outcome
• Young Adult