乙型肝炎抗原血症新生儿的随访

StephenW

乙型肝炎抗原血症新生儿的随访
静奇#1、刘慧娟#2、王立民#3、陈颖#4、傅家辉5、郑焕伟6、王春亚7、陈静8、王瑞芳9、潘照10
隶属关系
隶属关系

    1
    解放军总医院南方医学分院疾病预防控制科，北京，100071
    2
    中国人民解放军总医院第五医学中心（原北京302医院）新生儿科，北京，100039
    3
    清华大学北京清华长庚医院肝胆胰中心, 北京, 102218
    4
    150080,黑龙江省哈尔滨,解放军联勤保​​障部队962医院临床检验科
    5
    北京大学国际医院新生儿重症监护室，北京，102206
    6
    石家庄市第五医院，河北省石家庄市，050021
    7
    首都医科大学北京安贞医院，北京，100029
    8
    中国人民解放军总医院第五医学中心（原北京302医院）肝病科，北京，100039
    9
    解放军总医院第七医学中心妇产科，北京，100700
    10
    中国人民解放军总医院第五医学中心（原北京302医院）感染科，北京市西四环中路100号，100039 [email protected]。

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同等贡献。

    PMID：36282476 DOI：10.1007/s40121-022-00704-x

抽象的

引言：需要数据来评估感染乙型肝炎病毒 (HBV) 母亲的新生儿乙型肝炎抗原血症。本研究旨在对此进行调查。

方法：本研究招募血清乙型肝炎表面抗原（HBsAg）和/或e抗原（HBeAg）阳性的新生儿。

结果：纳入 98 名 HBV 感染母亲的 101 名新生儿。分娩时母体血清 HBV DNA 水平中位数为 23,200 IU/mL。新生儿中，男孩48人，女孩53人。平均出生体重为 3190.5 克。 21 名新生儿同时出现 HBsAg 和 HBeAg 血清阳性，9 名 HBsAg 和 HBeAg 血清阳性，71 名 HBsAg 和 HBeAg 血清阴性。 8 名新生儿可检测到血清 HBV DNA。随访中，HBV DNA 检测不到的新生儿血清 HBsAg 和 HBeAg 在 6 月龄前转为阴性。两名可检测到 HBV DNA 的婴儿被诊断为免疫预防失败，其中一名在 3 个月大时发展为活动性肝炎。该病例的肝活检显示明显的界面性肝炎、纤维间隔形成和汇管区扩大，偶有桥接纤维化。

结论：HBV感染母亲的新生儿并发HBV病毒血症和抗原血症需要注意，而无病毒血症的抗原血症通常是短暂的。

关键词：抗原血症；慢性肝炎；乙型肝炎病毒;新生。

© 2022。作者。

StephenW

Follow-Up of Newborns with Hepatitis B Antigenemia
Jing Qi #  1 , Huijuan Liu #  2 , Limin Wang #  3 , Ying Chen #  4 , Jiahui Fu  5 , Huanwei Zheng  6 , Chunya Wang  7 , Jing Chen  8 , Ruifang Wang  9 , Pan Zhao  10
Affiliations
Affiliations

    1
    Department of Disease Control and Prevention, Southern Medical Branch, Chinese PLA General Hospital, Beijing, 100071, China.
    2
    Neonatal Unit, Fifth Medical Center (Formerly Beijing 302 Hospital), Chinese PLA General Hospital, Beijing, 100039, China.
    3
    Hepato-Pancreato-Biliary Centre, Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing, 102218, China.
    4
    Department of Clinical Laboratory, 962 Hospital of PLA Joint Logistic Support Force, Harbin, 150080, Heilongjiang Province, China.
    5
    Neonatal Intensive Care Unit, Peking University International Hospital, Peking University, Beijing, 102206, China.
    6
    Fifth Hospital of Shijiazhuang, Shijiazhuang, 050021, Hebei Province, China.
    7
    Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China.
    8
    Department of Liver Diseases, Fifth Medical Center (Formerly Beijing 302 Hospital), Chinese PLA General Hospital, Beijing, 100039, China.
    9
    Department of Obstetrics and Gynecology, Seventh Medical Center, Chinese PLA General Hospital, Beijing, 100700, China.
    10
    Department of Infectious Diseases, Fifth Medical Center (Formerly Beijing 302 Hospital), Chinese PLA General Hospital, No. 100 of West Fourth Ring Middle Road, Beijing, 100039, China. [email protected].

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Contributed equally.

    PMID: 36282476 DOI: 10.1007/s40121-022-00704-x

Abstract

Introduction: There is a need for data to evaluate hepatitis B antigenemia in newborns of mothers with hepatitis B virus (HBV) infection. This study aims to investigate this.

Methods: Newborns with positive serum hepatitis B surface antigen (HBsAg) and/or e antigen (HBeAg) were enrolled in the study.

Results: One hundred and one newborns from 98 HBV-infected mothers were included. Median maternal serum HBV DNA level was 23,200 IU/mL at delivery. Among the newborns, 48 were boys and 53 were girls. Mean birth weight was 3190.5 g. Twenty-one newborns had concurrent seropositive HBsAg and HBeAg, nine had seropositive HBsAg and seronegative HBeAg, and 71 had seronegative HBsAg and seropositive HBeAg. Eight newborns had detectable serum HBV DNA. In the follow-up, serum HBsAg and HBeAg in the newborns with undetectable HBV DNA became negative before 6 months of age. Two infants with detectable HBV DNA were diagnosed with immunoprophylaxis failure, one of whom developed active hepatitis at 3 months of age. Liver biopsy in this case showed significant interface hepatitis, fibrous septa formation, and expansion of portal areas with occasional bridging fibrosis.

Conclusions: Concurrent HBV viremia and antigenemia in newborns of HBV-infected mothers requires attention, while antigenemia without viremia is often transient.

Keywords: Antigenemia; Chronic hepatitis; Hepatitis B virus; Newborn.

© 2022. The Author(s).

StephenW

https://link.springer.com/conten ... 121-022-00704-x.pdf