title: Risk factors associated with immunoprophylaxis failure against mother to child transmission of hepatitis B virus and hepatitis B vaccination status in Yunnan province, China.
abstract: OBJECTIVE
  To explore the risk factors associated with immunoprophylaxis failure against mother to child transmission of hepatitis B virus (HBV) and hepatitis B vaccination status in Yunnan province, China.
  
  
  METHODS
  Multicenter cluster sampling was used to select pregnant women who were positive for hepatitis B surface antigen (HBsAg). HBV immunoprophylaxis was carried out for the newborns. Blood samples were collected and tested for HBV markers from 7 to 10 month old infants. The factors were analyzed by univariate and logistic regression.
  
  
  RESULTS
  A total of 2765 mothers and their infants were enrolled. The failure rate of prevention of mother to child transmission (PMTCT) was 4.12%. The rate of timely HepB1 vaccination within 24h was 98.04%, the rate of three-dose vaccination was 92.30% and the rate of hepatitis B immune globulin (HBIG) administration was 68.97%. Place of residence, maternal education, gestational age and birth weight were related to administration of HBV immunoprophylaxis. It was remarkable that the rate of HBIG administration of infants was only 63.89% with whose mothers were both HBsAg and hepatitis B e antigen (HBeAg)-positive. Further analysis showed that there were three risk factors associated with HBV immunoprophylaxis failure: mothers who were positive for HBsAg and HBeAg, maternal HBVDNA level, and HBIG administration or not.
  
  
  CONCLUSIONS
  PMTCT of HBV was well implemented in Yunnan. However, in order to achieve optimal prevention of vertical HBV transmission, it is mandatory to make additional efforts to improve the implementation of regulatory HBV immunoprophylaxis, especially for HBsAg-positive pregnant women.
authors.affiliation: Center for Disease Control and Prevention of Yunnan Province, Kunming 650022, China.
authors.forename: Wenyu
authors.initials: W
authors.lastname: Kang
authors.affiliation: Center for Disease Control and Prevention of Yunnan Province, Kunming 650022, China.
authors.forename: Zhengrong
authors.initials: Z
authors.lastname: Ding
authors.affiliation: National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China. Electronic address: slpss128@126.com.
authors.forename: Liping
authors.initials: L
authors.lastname: Shen
authors.affiliation: Center for Disease Control and Prevention of Yunnan Province, Kunming 650022, China.
authors.forename: Zhixian
authors.initials: Z
authors.lastname: Zhao
authors.affiliation: Center for Disease Control and Prevention of Yunnan Province, Kunming 650022, China.
authors.forename: Guofei
authors.initials: G
authors.lastname: Huang
authors.affiliation: Center for Disease Control and Prevention of Yunnan Province, Kunming 650022, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Center for Disease Control and Prevention of Yunnan Province, Kunming 650022, China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Xiong
authors.affiliation: National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
authors.forename: Shuang
authors.initials: S
authors.lastname: Zhang
authors.affiliation: National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
authors.forename: Shuo
authors.initials: S
authors.lastname: Zhang
authors.affiliation: National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Wang
mesh_terms: D002681:China / Q000453:epidemiology; D004279:DNA, Viral / Q000097:blood; D005260:Female; D006509:Hepatitis B / Q000517:prevention & control*; D006514:Hepatitis B Surface Antigens / Q000097:blood; D017325:Hepatitis B Vaccines / Q000627:therapeutic use*; D006513:Hepatitis B e Antigens / Q000097:blood; D006801:Humans; D007136:Immunoglobulins / Q000627:therapeutic use; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology*; D012307:Risk Factors
chemical_list: D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens; D017325:Hepatitis B Vaccines; D006513:Hepatitis B e Antigens; D007136:Immunoglobulins; C045213:hepatitis B hyperimmune globulin
keywords: Hepatitis B virus; Immunoprophylaxis; Mother-to-child transmission; Risk factor