title: Serum ALT levels as a surrogate marker for serum HBV DNA levels in HBeAg-negative pregnant women.
abstract: In Stockholm, Sweden, the majority of pregnant women positive for hepatitis B surface antigen (HBsAg) are hepatitis Be antigen (HBeAg) negative. Newborns to HBeAg positive mothers receive vaccination and hepatitis B immunoglobulin (HBIg). Newborns to HBeAg negative mothers receive vaccine and HBIg only if the mothers have elevated ALT levels. The aim of this study was to retrospectively evaluate ALT levels as a surrogate marker for HBV DNA levels in HBeAg negative carrier mothers. Altogether 8947 pregnant women were screened for HBV markers from 1999 to 2001 at the Virology Department, Karolinska Hospital. Among mothers screened 192 tested positive for HBsAg (2.2%). 13 of these samples could not be retrieved. Of the remaining 179 sera, 8 (4%) tested positive for HBeAg and 171 (95.5%) were HBeAg negative. Among the HBeAg negative mothers, 9 had HBV DNA levels > 10(5) copies/ml, and of these 7 had normal ALT levels indicating low sensitivity of an elevated ALT level as a surrogate marker for high HBV DNA level. Furthermore, no correlation was found between ALT and HBV DNA levels. Hence, it is concluded that the use of ALT as a surrogate marker for high viral replication in HBeAg negative mothers could be questioned.
authors.affiliation: Department of Medical Sciences, Section of Infectious Diseases, Akademiska Hospital, Uppsala, Sweden. per.sangfelt@medsci.uu.se
authors.forename: Per
authors.initials: P
authors.lastname: Sangfelt
authors.forename: Madeleine
authors.initials: M
authors.lastname: Von Sydow
authors.forename: Ingrid
authors.initials: I
authors.lastname: Uhnoo
authors.forename: Ola
authors.initials: O
authors.lastname: Weiland
authors.forename: Gudrun
authors.initials: G
authors.lastname: Lindh
authors.forename: Björn
authors.initials: B
authors.lastname: Fischler
authors.forename: Susanne
authors.initials: S
authors.lastname: Lindgren
authors.forename: Olle
authors.initials: O
authors.lastname: Reichard
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood*; D001483:Base Sequence; D015415:Biomarkers / Q000097:blood; D002353:Carrier State / Q000635:transmission*; D016022:Case-Control Studies; D016001:Confidence Intervals; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006509:Hepatitis B / Q000517:prevention & control / Q000635:transmission*; D006513:Hepatitis B e Antigens / Q000032:analysis*; D006515:Hepatitis B virus / Q000276:immunology* / Q000302:isolation & purification; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008403:Mass Screening; D008969:Molecular Sequence Data; D016133:Polymerase Chain Reaction / Q000379:methods; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis; D011256:Pregnancy Outcome; D011295:Prenatal Care; D011336:Probability; D012016:Reference Values; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012698:Serologic Tests; D018709:Statistics, Nonparametric; D013548:Sweden
chemical_list: D015415:Biomarkers; D004279:DNA, Viral; D006513:Hepatitis B e Antigens; D000410:Alanine Transaminase