title: Occult hepatitis B virus infection in children born to HBsAg-positive mothers after neonatal passive-active immunoprophylaxis.
abstract: BACKGROUND
  Occult hepatitis B virus infection (OBI) is a well-recognized clinical entity characterized by the detection of HBV DNA in serum and/or liver in the absence of detectable HBsAg. Diagnosis of OBI requires a sensitive HBV DNA assay.
  
  
  OBJECTIVE
  We aimed at determining the frequency of OBI in infants, born to HBsAg-positive mothers, who received immunoprophylaxis at birth.
  
  
  METHODS
  Sixty-four infants and children, born to HBsAg-positive mothers, who received hepatitis B immunoglobulin and HBV vaccine within 48 h after birth, were tested for HBV serological profile and HBV DNA by real-time PCR at least 1 month after last dose of HBV vaccine and not before 6 months of age.
  
  
  RESULTS
  The median age of the studied infants and children was 8 months, ranging from 6 to 132 months; 54.7 % were females. HBV DNA was detected in 2 infants. One case had OBI; she was negative for HBsAg, anti-HBc total, HBeAg and was positive for anti-HBs (titer 267 mIU/mL) with low level of viremia (HBV DNA 1.13 x 10(3) IU/mL). Another infant showed immunoprophylaxis failure with positive HBsAg, anti-HBc total, HBeAg, negative anti-HBe and anti-HBs; HBV viral load was 1.7 × 10(8) IU/mL. Both mothers were HBsAg and HBeAg-positive.
  
  
  CONCLUSIONS
  OBI may occur in infants born to HBsAg-positive mothers despite the receipt of immunoprophylaxis. OBI was detected in a low frequency in the present study. Anti-HBs positivity does not exclude OBI.
authors: Department of Pediatrics, National Hepatology and Tropical Medicine Research Institute, 7101 El-Kahera Buildings, El-Mokattam, Cairo, 11415, Egypt, hananminaped@gmail.com.
authors: Hanan
authors: H
authors: Foaud
authors: Sahar
authors: S
authors: Maklad
authors: Faten
authors: F
authors: Mahmoud
authors: Hanaa
authors: H
authors: El-Karaksy
mesh_terms: D001769:Blood / Q000821:virology; D002648:Child; D002675:Child, Preschool; D004279:DNA, Viral / Q000097:blood*; D005260:Female; D006509:Hepatitis B / Q000175:diagnosis* / Q000473:pathology / Q000517:prevention & control*; D006514:Hepatitis B Surface Antigens / Q000097:blood*; D006515:Hepatitis B virus / Q000302:isolation & purification*; D006801:Humans; D007116:Immunization, Passive; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011446:Prospective Studies; D060888:Real-Time Polymerase Chain Reaction; D014611:Vaccination; D014766:Viremia / Q000175:diagnosis
chemical_list: D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens