Risk of hepatitis B transmission in breast-fed infants of chronic hepatitis B carriers.
OBJECTIVE
To measure the rate of hepatitis B (HBV) transmission from chronic HBV carriers to breast-fed infants after immunoprophylaxis.


METHODS
Since 1992, information on women with HBV during pregnancy has been collected in a prospective longitudinal study. Those HBV carriers and their infants participating in a county HBV immunoprophylaxis program were identified. Infants were followed for up to 15 months and examined for hepatitis B infection by hepatitis B surface antigen (HBsAg).


RESULTS
A total of 369 infants born to women with chronic HBV met the inclusion criteria and received hepatitis B immune globulin at birth and the full course of the hepatitis B vaccine series. We compared 101 breast-fed infants with 268 formula-fed infants. There was no significant difference between the two groups with respect to the number of women who were positive for hepatitis B e antigen (HBeAg) (22% versus 26%, P =.51). Three women in the breast-feeding group had liver transaminase abnormalities, compared with six women in the formula-feeding group (P =.29). Overall, there were nine cases of HBV infection transmission (2.4%). None of the 101 breast-fed infants and nine formula-fed infants (3%) were positive for HBsAg after the initial vaccination series (P =.063). The mean length of time for breast-feeding was 4.9 months (range 2 weeks to 1 year).


CONCLUSIONS
With appropriate immunoprophylaxis, including hepatitis B immune globulin and hepatitis B vaccine, breast-feeding of infants of chronic HBV carriers poses no additional risk for the transmission of the hepatitis B virus.
Hill
James B
JB
Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center at Dallas, 75235-9032, USA. james.hill@utsouthwestern.edu
Sheffield
Jeanne S
JS
Kim
Matthew J
MJ
Alexander
James M
JM
Sercely
Barbara
B
Wendel
George D
GD
D000293:Adolescent; D000328:Adult; D001942:Breast Feeding / Q000009:adverse effects*; D002908:Chronic Disease; D015331:Cohort Studies; D005260:Female; D006509:Hepatitis B / Q000517:prevention & control* / Q000635:transmission*; D006514:Hepatitis B Surface Antigens / Q000097:blood; D017325:Hepatitis B Vaccines; D006801:Humans; D007116:Immunization, Passive; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control / Q000706:statistics & numerical data*; D008137:Longitudinal Studies; D011247:Pregnancy; D011446:Prospective Studies; D012307:Risk Factors; D013781:Texas / Q000453:epidemiology
D006514:Hepatitis B Surface Antigens; D017325:Hepatitis B Vaccines