Long-term effect of maternal HBeAg on delayed HBeAg seroconversion in offspring

StephenW

<http://onlinelibrary.wiley.com/doi/10.1111/j.1478-3231.2011.02574.x/abstract>

Long-term effect of maternal HBeAg on delayed HBeAg seroconversion in
offspring with chronic hepatitis B infection

Yu-Ru Tseng1, Jia-Feng Wu1, Yen-Hsuan Ni1, Huey-Ling Chen1, Chih-Cheng
Chen2, Wan-Hsin Wen3, Hong-Yuan Hsu1, Mei-Hwei Chang1

Article first published online: 28 JUN 2011

DOI: 10.1111/j.1478-3231.2011.02574.x

© 2011 John Wiley & Sons A/S
Issue

Liver International
Volume 31, Issue 9, pages 1373–1380, October 2011

Abstract

Background and aims: This cohort study investigated the long-term effect of
maternal hepatitis B virus (HBV) sero-status on the spontaneous HBeAg
seroconversion in offspring with chronic HBV infection.

Methods: A total of 185 HBeAg-positive chronic HBV-infected children, with
maternal HBV seromarkers checked, were enrolled. The median age at
enrolment and follow-up duration was 5.7 years (range, neonate to 16.5
years) and 20.2 years (range, 4.2–31.0 years) respectively. These
children were grouped according to the initial maternal HBsAg and HBeAg
status: (i) children of non-carrier mothers (n=48); (ii) children of
HBeAg-negative chronic HBV-infected mothers (n=57); (iii) children of
HBeAg-positive chronic HBV-infected mothers (n=80). HBV seromarkers and
liver function profiles of these children were performed at 6-month
intervals.

Results: One hundred and twenty-one (65.4%) subjects had achieved
spontaneous HBeAg seroconversion at the end of this follow-up study.
Spontaneous HBeAg seroconversion was achieved in 83.3% of children with
non-carrier mothers, 73.7% of children with HBeAg-negative chronic
HBV-infected mothers and 48.8% of children with HBeAg-positive mothers
during similar duration (P<0.001). Positive maternal HBeAg and genotype C
were associated with delayed spontaneous HBeAg seroconversion in
multivariate analysis (P=0.01 and P=0.002 respectively). In children of
HBeAg-positive chronic HBV-infected mothers, persistent presence of
maternal HBeAg showed a trend of association with delayed HBeAg
seroconversion in their offspring (P=0.06). Children of late maternal HBeAg
seroconversion (>40 years old) had delayed HBeAg seroconversion compared
with those of early HBeAg seroconversion mothers (P=0.06).

Conclusions: Persistence of maternal HBeAg is an important risk factor for
delayed spontaneous HBeAg seroconversion in children with chronic HBV
infection.



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StephenW

HBeAg的母亲延迟后代HBeAg血清转换的长期效果.
就个人而言，我觉得很难理解这一研究。母亲感染的儿童血清转换需要较长时间？

背景和目的：此队列研究调查的长期影响
产妇B型肝炎病毒（HBV）的自发性HBeAg血清状况
在慢性HBV感染者的后代的血清学转换。

方法：共有185 HBeAg阳性慢性乙型肝炎病毒感染的儿童，
产妇乙肝seromarkers检查，登记。年龄中位数
入学率和随访时间为5.7年（范围，新生儿至16.5
年），分别为20.2岁（范围4.2-31.0年）。这些
根据初步的产妇乙肝表面抗原和HBeAg的孩子们分组
状态：（i）儿童的非携带者的母亲（N = 48）;（二）儿童
HBeAg阴性慢性乙肝病毒感染的母亲（N =57）;（三）儿童
HBeAg阳性的慢性乙肝病毒感染的母亲（N = 80）。乙肝seromarkers和
这些儿童的肝功能配置文件均在6个月
间隔。

结果：取得了一百二十一（65.4％）科目
在这个后续研究结束时自发HBeAg血清转换。
自发性HBeAg血清学转换是实现83.3％的儿童
非携带者的母亲，73.7％的儿童与HBeAg阴性慢性
HBV感染的母亲和48.8％的HBeAg阳性母亲的儿童
在类似的持续时间（P <0.01）。阳性产妇HBeAg和C基因型
与延迟自发HBeAg血清转换
多变量分析（P = 0.001和P= 0.002）。在儿童
HBeAg阳性的慢性乙肝病毒感染的母亲，持续存在的
产妇HBeAg的显示延迟HBeAg的趋势的关联
在他们的后代血清转换（P = 0.06）。儿童晚期产妇HBeAg的
血清转换（> 40岁）已推迟HBeAg血清学转换比较
与早期HBeAg血清转换的母亲（P = 0.06）。

结论：产妇HBeAg的持久性是一个重要的危险因素
延迟在慢性乙肝儿童自发HBeAg血清转换
感染。

把握当下

结论：Persistence of maternal HBeAg is an important risk factor for delayed spontaneous HBeAg seroconversion in children with chronic HBV infection.
---母方e抗原持续阳性对儿童感染乙型肝炎后e抗原自发清除时间增长有重要影响。

我觉得问题其实不在于母方e抗原是不是持续阳性，而是感染hbv时病人的年龄对病人今后自发产生e血清转化的影响。

例如，如果经过有效阻断，母方e抗原阳性对儿童根本就没有影响，儿童不会感染乙肝，也就没有后面的“血清转换”问题。当然，论文可能讨论的是没有任何人工干预（生育时不查乙肝，不阻断）的情况

StephenW

回复 把握当下 的帖子

我非常同意。他们只讨论受感染的儿童，垂直或水平的感染.