Increased Protection of Earlier Use of Immunoprophylaxis in Preventing Perinatal Transmission of Hepatitis B Virus.

Abstract

BACKGROUND:

Passive-active immunoprophylaxis against mother-to-child transmission (MTCT) of hepatitis B virus (HBV) recommends administering hepatitis B immunoglobulin (HBIG) and birth-dose hepatitis B vaccine in infants within 12 or 24 hours after birth. With this protocol, MTCT of HBV still occurs in 5-10% infants of HBV-infected mothers with positive hepatitis B e antigen (HBeAg). The present study aimed to investigate whether earlier administration of HBIG and hepatitis B vaccine after birth can further increase protection efficacy.

METHODS:

We conducted a prospective, multi-center observational study in infants born to mothers with HBV infection, in whom neonatal HBIG and birth dose hepatitis B vaccine were administered within one hour after birth. The infants were followed up for HBV markers at 7-14 months of age.

RESULTS:

A total of 1140 pregnant women with HBV were enrolled, and 982 infants (9 twins) of 973 mothers were followed up at 9.6 ± 1.9 months of age. HBIG and birth-dose vaccine were administered in newborn infants within a median of 0.17 (0.02-1.0) hours after birth. The overall rate of MTCT was 0.9% (9/982), with none (0%) of the 607 infants of HBeAg-negative mothers and 9 (2.4%) of 375 infants of HBeAg-positive mothers acquiring HBV. All 9 HBV-infected infants were born to mothers with HBV DNA >2.75 × 106 IU/mL. Maternal HBV DNA levels >2 × 106 IU/mL were an independent risk factor (odds ratio, 10.627; 95% confidence interval, 2.135-∞) for immunoprophylaxis failure.

CONCLUSIONS:

Earlier use (within 1 hour after birth) of HBIG and hepatitis B vaccine can provide better protection efficacy against MTCT of HBV.

• Authors: Hongyu Huang, Chenyu Xu, Lanhua Liu, Liping Chen, Xiaoqin Zhu, Jie Chen, Jing Feng, Tingmei Chen, Biao Xu, Jishi Yang, Biyun Xu, Mingjie Pan, Yimin Dai, Yali Hu, Yi-Hua Zhou
• Journal: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America (Clin Infect Dis) Vol. 73 Issue 9 Pg. e3317-e3323 (11 02 2021) ISSN: 1537-6591 [Electronic] United States
• PMID: 32634824 (Publication Type: Journal Article, Observational Study, Research Support, Non-U.S. Gov't)
• Copyright: © The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: [email protected].

Chemical References

• Hepatitis B Surface Antigens
• Hepatitis B Vaccines
• Hepatitis B e Antigens

Topics

• Female
• Hepatitis B (prevention & control)
• Hepatitis B Surface Antigens
• Hepatitis B Vaccines
• Hepatitis B e Antigens
• Hepatitis B virus
• Humans
• Infant
• Infant, Newborn
• Infectious Disease Transmission, Vertical (prevention & control)
• Pregnancy
• Pregnancy Complications, Infectious (prevention & control)
• Prospective Studies