Outcome of perinatal hepatitis B virus exposure is dependent on maternal virus load.
To evaluate the role of maternal hepatitis B virus (HBV) DNA levels in perinatal infection, two nested case-control studies were done within a cohort of 773 hepatitis B surface antigen (HBsAg)-positive Taiwanese women and their infants. As serum HBV DNA levels increased from < 0.005 to > or = 1.4 ng/mL among the hepatitis B e antigen (HBeAg)-positive mothers, the odds ratio (OR) for having a persistently infected infant increased from 1.0 to 147.0 (P for trend < .001). Among HBeAg-negative mothers, the OR for having a persistently infected infant was 19.2 (95% confidence interval, 2.3-176.6) in mothers with high versus low levels of serum HBV DNA. A logistic regression analysis identified maternal HBV DNA to be a stronger independent predictor of persistent infection than HBeAg status. Thus, perinatal exposure to high levels of maternal HBV DNA is the most important determinant of infection outcome in the infant.
Burk
R D
RD
Marion Bessin Liver Research Center, Albert Einstein College of Medicine, Bronx, New York 10461.
Hwang
L Y
LY
Ho
G Y
GY
Shafritz
D A
DA
Beasley
R P
RP
D016022:Case-Control Studies; D002908:Chronic Disease; D015331:Cohort Studies; D004279:DNA, Viral / Q000097:blood*; D005260:Female; D006509:Hepatitis B / Q000635:transmission* / Q000821:virology*; D006510:Hepatitis B Antibodies / Q000097:blood; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006513:Hepatitis B e Antigens / Q000097:blood*; D006515:Hepatitis B virus / Q000502:physiology*; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D016017:Odds Ratio; D012044:Regression Analysis; D013624:Taiwan
D004279:DNA, Viral; D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens; D006513:Hepatitis B e Antigens