Dig Liver Dis. 2018 Nov 20. pii: S1590-8658(18)31222-2. doi: 10.1016/j.dld.2018.11.003. [Epub ahead of print]
Presence of hepatitis B virus markers in umbilical cord blood: Exposure to or infection with the virus?
Liu J1, Xu B2, Chen T3, Chen J4, Feng J4, Xu C3, Liu L2, Hu Y4, Zhou YH5.
Author information
1
Department of Laboratory Medicine, Nanjing Drum Tower Hospital and Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing, China.
2
Department of Obstetrics and Gynecology, Taixing People's Hospital, Taixing, China.
3
Department of Obstetrics and Gynecology, Zhenjiang Fourth People's Hospital, Zhenjiang, China.
4
Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, China.
5
Department of Laboratory Medicine, Nanjing Drum Tower Hospital and Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing, China; Department of Infectious Diseases, Nanjing Drum Tower Hospital, Nanjing Medical University, Nanjing, China. Electronic address: [email protected].
Abstract
BACKGROUND:
We aimed to clarify whether presence of hepatitis B virus (HBV) markers in cord blood indicates exposure to or infection with HBV.
METHODS:
We prospectively recruited HBsAg-positive pregnant women and their neonates 2012 through 2015. All neonates received postnatal immunoprophylaxis. The infants were followed up at 7-14 months of age.
RESULTS:
Totally 329 HBsAg-positive pregnant women and 333 neonates were enrolled. No cord blood was anti-HBc IgM positive. A total of 290 (87.1%) neonates were followed up at 7-14 months of age and 6 (2.1%) of them were infected with HBV. Of 146 neonates born to HBeAg-negative mothers, 38 (26.0%) and 30 (20.5%) had detectable HBsAg and HBV DNA in cord blood respectively, but none of 126 infants followed up was infected. Of 187 neonates born to HBeAg-positive mothers, 92 (49.2%) and 79 (42.2%) had detectable HBsAg and HBV DNA in cord blood respectively; 6 (3.7%) of 164 infants followed up were infected. Of seven neonates with HBV DNA > 105 IU/ml in cord blood, four had no infection and three others were infected.
CONCLUSION:
Presence of HBsAg and/or HBV DNA, even at high levels, in cord blood just indicates exposure to, but not infection with HBV. Presence of HBV markers in cord blood cannot define intrauterine infection.