Received 27 July 2010; received in revised form 10 November 2010; accepted 16
November 2010. published online 17 December 2010. Corrected Proof
Abstract
Background
Hepatitis B virus infection is an important public health problem worldwide and
eliminating mother-to-infant transmission is important to decrease the
prevalence of chronic HBV-infection. Although, immunoprophylaxis given at birth
largely prevents mother-to-infant transmission, perinatal HBV viremia has been
reported in HBsAg(−) newborns born mainly to HBeAg(+) women in endemic areas.
Objectives
To examine the incidence of perinatal HBV viremia in newborns of HBsAg(+)
predominantly HBeAg(−) mothers.
Study design
Peripheral blood was obtained at birth from 109 HBsAg(+) mothers and their
newborns before the administration of active–passive immunoprophylaxis.
Infants were prospectively followed and appropriately vaccinated.
Results
Although most (92.7%) of the HBsAg(+) mothers were HBeAg(−), 73.4% had
detectable HBV viremia. Neonatal viremia was detected in 3/8 (37.5%) and 24/101
(23.8%) newborns of HBeAg(+) and HBeAg(−) mothers, respectively (p=0.386).
However, HBV–DNA levels were significantly higher in newborns of HBeAg(+)
mothers (p=0.025). No child developed chronic HBV infection, but one child had
evidence of subclinical hepatitis.
Conclusions
Although the clinical significance of low viremia levels in almost one in four
newborns of HBsAg(+) mothers in a low endemicity area is unclear, it may enhance
our understanding of HBV mother-to-infant transmission.
a Second Department of Pediatrics, “P& A Kyriakou” Children's Hospital,
Medical School, Athens University, Goudi 11527, Athens, Greeceb Department of
Hygiene, Epidemiology and Medical Statistics, Medical School, Athens University,
Greecec First Department of Obstetrics and Gynecology, Alexandra Hospital,
Medical School, University of Athens, Athens, Greeced Neonatology Department,
Alexandra Hospital, Athens, Greece
Corresponding author. Tel.: +30 2107793000; fax: +30 2107774383.
1 Current address: First Department of Pediatrics, “A. Sophia” Children's
Hospital, Medical School, Athens University, Greece.