Maternal HBeAg positivity and viremia associated with umbilical cord blood hepatitis B viremia

Pediatr Neonatol. 2019 Oct;60(5):517-522. doi: 10.1016/j.pedneo.2019.01.002. Epub 2019 Jan 5.

Abstract

Background: Hepatitis B (HBV) transmission may result from in utero transmission. We aimed to determine the correlation between maternal serum and umbilical cord blood HBV DNA levels in infants delivered by chronic HBV-infected mothers and to describe the effect of cord blood viremia on vertical transmission.

Methods: A prospective cohort of 92 chronic HBV-infected mother-and-child pairs recruited over three years was analyzed. Maternal and cord blood were tested for HBV DNA by real-time PCR. Standard immunoprophylaxis with both active and passive immunization was administered to all infants. Serological testing was performed on all infants at 9 months of age.

Results: Moderate positive correlation of the maternal HBV DNA with cord blood HBV DNA was demonstrated (r2 = 0.521, p = <0.001). HBeAg +ve mothers were younger with higher HBV and cord viremia. At 9 months of age, one infant was infected. Infants delivered by HBeAg positive mothers and mothers with high HBV DNA of more than 6 LOG IU/mL (1 x 106 IU/mL) have increased relative risk of cord blood viremia.

Conclusions: Maternal HBV DNA and presence of HBeAg were positively correlated to cord blood HBV DNA in infants delivered by chronic HBV-infected mothers. Our data suggest that reducing maternal viremia during the antenatal period may help to reduce cord blood viremia.

Keywords: cord blood hepatitis B viral (HBV) DNA; hepatitis B core antibody; in-utero exposure to HBV; maternal hepatitis B viral (HBV) DNA.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • DNA, Viral / blood
  • Female
  • Fetal Blood / virology*
  • Hepatitis B e Antigens / blood*
  • Hepatitis B, Chronic / virology*
  • Humans
  • Infant
  • Infant, Newborn
  • Infectious Disease Transmission, Vertical*
  • Pregnancy
  • Pregnancy Complications, Infectious / virology*
  • Viremia / virology*

Substances

  • DNA, Viral
  • Hepatitis B e Antigens