title: Maternal transmission risk and antibody levels against hepatitis B virus e antigen in pregnant women.
abstract: BACKGROUND
  The generation of antibodies (anti-HBe) against hepatitis B virus (HBV) e antigen (HBeAg) often coincides with clinical remission in chronic HBV patients. We aimed to examine the effect of maternal anti-HBe in protection against HBV mother-to-child transmission (MTCT).
  
  
  METHODS
  A total of 140 chronic HBV-infected pregnant women participated in this study. Before delivery, maternal HBV serological markers and HBV viral load were determined and anti-HBe titers were semi-quantified. Neonatal hepatitis B surface antigen (HBsAg) and HBV-DNA status were determined from cord blood. The children were followed to age 1-3 years.
  
  
  RESULTS
  The HBV-DNA positive rate in cord blood was 75.61% (31/41) in those who were born to mothers with serum HBV-DNA >10(6) IU/ml, which was significantly higher than in those who were born to mothers with HBV-DNA <10(6) IU/ml (3/99, 3.03%; p<0.0001). However, 10 newborns from mothers with serum HBV-DNA >10(6) IU/ml had no detectable HBV-DNA in cord blood; anti-HBe was positive with a median titer of 10 (interquartile range 10-55). A total of 84 children who received hepatitis B immune globulin (HBIG) within 12h after birth and who completed three doses of recombinant HBV vaccination were followed to age 1-3 years (up to May 2014). All 56 children who were born to mothers with serum HBV-DNA levels <10(6) IU/ml were HBsAg-negative. Five of the 22 children born to anti-HBe-negative mothers with serum HBV-DNA >10(6) IU/ml acquired an HBsAg-positive status. However, none of the six children who were born to anti-HBe-positive/weak-positive mothers with serum HBV-DNA >10(6) IU/ml acquired an HBsAg-positive status.
  
  
  CONCLUSIONS
  The presence of maternal anti-HBe is protective against HBV MTCT, independent of the maternal serum HBV viral load.
authors.affiliation: State Key Laboratory of Molecular Oncology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Beijing 100021, China; Qidong Liver Cancer Institute and Qidong People's Hospital, Qidong 226200, Jiangsu Province, China.
authors.forename: Ling-Ling
authors.initials: LL
authors.lastname: Lu
authors.affiliation: Qidong Liver Cancer Institute and Qidong People's Hospital, Qidong 226200, Jiangsu Province, China.
authors.forename: Bing-Xiang
authors.initials: BX
authors.lastname: Chen
authors.affiliation: Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China.
authors.forename: Jiandong
authors.initials: J
authors.lastname: Wang
authors.affiliation: State Key Laboratory of Molecular Oncology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Beijing 100021, China.
authors.forename: Dongmei
authors.initials: D
authors.lastname: Wang
authors.affiliation: State Key Laboratory of Molecular Oncology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Beijing 100021, China.
authors.forename: Yue
authors.initials: Y
authors.lastname: Ji
authors.affiliation: State Key Laboratory of Molecular Oncology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Beijing 100021, China.
authors.forename: Hong-Gan
authors.initials: HG
authors.lastname: Yi
authors.affiliation: State Key Laboratory of Molecular Oncology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Beijing 100021, China.
authors.forename: Taoyang
authors.initials: T
authors.lastname: Chen
authors.affiliation: National Office for Cancer Prevention and Control, Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Yue
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Infectious Disease, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Eskild
authors.initials: E
authors.lastname: Petersen
authors.affiliation: Qidong Liver Cancer Institute and Qidong People's Hospital, Qidong 226200, Jiangsu Province, China. Electronic address: qdmjgliqin@163.com.
authors.forename: Qin
authors.initials: Q
authors.lastname: Li
authors.affiliation: State Key Laboratory of Molecular Oncology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Beijing 100021, China. Electronic address: quchf@cicams.ac.cn.
authors.forename: Chunfeng
authors.initials: C
authors.lastname: Qu
mesh_terms: D000328:Adult; D002648:Child; D002675:Child, Preschool; D004279:DNA, Viral / Q000097:blood; D005260:Female; D006510:Hepatitis B Antibodies / Q000097:blood*; D006513:Hepatitis B e Antigens / Q000276:immunology*; D006515:Hepatitis B virus / Q000235:genetics; D019694:Hepatitis B, Chronic / Q000276:immunology / Q000635:transmission* / Q000821:virology; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000276:immunology; D012306:Risk; D055815:Young Adult
chemical_list: D004279:DNA, Viral; D006510:Hepatitis B Antibodies; D006513:Hepatitis B e Antigens
keywords: Antibodies against HBeAg; Hepatitis B virus; Mother-to-child transmission