title: Vertical transmission of hepatitis B virus (HBV) from mothers negative for HBV surface antigen and positive for antibody to HBV core antigen.
abstract: BACKGROUND
  Hepatitis B virus (HBV) can be transmitted by blood donors and organ donors who are positive for antibody to HBV core antigen (anti-HBc) but negative for all other HBV markers. Therefore, we evaluated the risk of infection for babies of mothers with this serostatus.
  
  
  METHODS
  A total of 2365 HBV surface antigen (HBsAg)-negative pregnant women were included in the study and screened for anti-HBc. Blood samples for screening were collected 1 day before or after delivery. Infants of mothers with positive anti-HBc test results were tested 3-4 months after birth.
  
  
  RESULTS
  Of 2365 mothers, 147 (6.2%) were anti-HBc positive. Follow-up tests were performed using samples from 105 children. Samples were tested for all HBV markers, including HBV DNA, which was evaluated using a highly sensitive polymerase chain reaction assay (Taq PCR). Seven children (6.6%) had markers of HBV infection; the Taq PCR detected HBV DNA in 5, and HBsAg was detected in the other 2.
  
  
  CONCLUSIONS
  This study shows that HBV can be transmitted perinatally even in the absence of HBsAg. None of the children developed chronic HBV infection. Further studies must determine whether routine immunization of infants at the age of 3 months gives enough protection against HBV infection or whether screening of pregnant women for HBV should be extended, with immunization of their newborns beginning immediately after birth.
authors.affiliation: Childrens Hospital Helios Klinikum Wuppertal, Witten-Herdecke University, Witten, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Walz
authors.forename: Stefan
authors.initials: S
authors.lastname: Wirth
authors.forename: Jürgen
authors.initials: J
authors.lastname: Hucke
authors.forename: Patrick
authors.initials: P
authors.lastname: Gerner
mesh_terms: D000328:Adult; D004279:DNA, Viral / Q000097:blood; D005260:Female; D006509:Hepatitis B / Q000276:immunology / Q000635:transmission* / Q000821:virology; D006510:Hepatitis B Antibodies / Q000097:blood*; D006512:Hepatitis B Core Antigens / Q000097:blood*; D006514:Hepatitis B Surface Antigens / Q000097:blood*; D006801:Humans; D007223:Infant; D018445:Infectious Disease Transmission, Vertical; D055815:Young Adult
chemical_list: D004279:DNA, Viral; D006510:Hepatitis B Antibodies; D006512:Hepatitis B Core Antigens; D006514:Hepatitis B Surface Antigens