Pediatr Neonatol. 2019 Jan 5. pii: S1875-9572(18)30508-4. doi: 10.1016/j.pedneo.2019.01.002. [Epub ahead of print]
Maternal HBeAg positivity and viremia associated with umbilical cord blood hepatitis B viremia.
Lee LY1, Lee GH2, Mattar C3, Saw S4, Aw M5.
Author information
1
Department of Neonatology, National University Hospital, Singapore; Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. Electronic address: [email protected].
2
Department of Medicine, National University Hospital, Singapore; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
3
Department of Obstetrics and Gynaecology, National University Hospital, Singapore; Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
4
Department of Laboratory Medicine, National University Hospital, Singapore.
5
Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore.
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.