title: Perinatal transmission of the hepatitis B virus and of the HBV-associated delta agent from mothers to offspring in northern Italy.
abstract: We report a prospective study on infants born to hepatitis B surface antigen (HBsAg) carrier mothers to estimate the incidence of perinatal transmission of HBV and HBV-associated delta agent in Northern Italy. The risk of infection to the infant was related to the presence of the HBe antigen-antibody system, HBV-specific DNA polymerase activity and antibody to delta in maternal sera, and to the titer of anti-HBe in babies at birth. The data of this study indicate: 1. Babies born to HBsAg carrier mothers with HBeAg in serum are at extremely high risk of acquiring HBV infection and of developing a chronic carrier state, whereas those born to anti-HBe-positive mothers are at a lower (P less than .01) yet consistent risk of infection. 2. HBs antigenemia is usually prolonged and symptomatic in babies born to HBeAg-positive mothers while being self-limited and asymptomatic in babies born to anti-HBe-positive mothers. 3. DNA polymerase activity in maternal serum appears to be the most sensitive marker predicting HBV transmission to the infant since it was detected in all the HBeAg-positive mothers and also in two anti-HBe-positive mothers and in one HBeAg/anti-HBe-negative mother who transmitted infection to their babies. 4. High titers of anti-HBe (up to 1:103) do not prevent HBV infection. 5. Vertical transmission of delta infection seems to occur only in circumstances that permit perinatal transmission of HBV infection.
mesh_terms: D000914:Antibodies, Viral / Q000032:analysis*; D002353:Carrier State; D004259:DNA-Directed DNA Polymerase / Q000097:blood; D003673:Defective Viruses / Q000276:immunology; D005260:Female; D006509:Hepatitis B / Q000276:immunology / Q000635:transmission*; D006510:Hepatitis B Antibodies / Q000032:analysis*; D006511:Hepatitis B Antigens / Q000276:immunology*; D006514:Hepatitis B Surface Antigens; D006513:Hepatitis B e Antigens / Q000276:immunology; D035923:Hepatitis delta Antigens; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007558:Italy; D011247:Pregnancy; D011446:Prospective Studies
chemical_list: D000914:Antibodies, Viral; D006510:Hepatitis B Antibodies; D006511:Hepatitis B Antigens; D006514:Hepatitis B Surface Antigens; D006513:Hepatitis B e Antigens; D035923:Hepatitis delta Antigens; D004259:DNA-Directed DNA Polymerase