title: No response to hepatitis B vaccine in infants born to HBsAg(+) mothers is associated to the transplacental transfer of HBsAg.
abstract: BACKGROUND
  No or low hepatitis B (HB) vaccine response is more frequent in infants from HBsAg(+) mothers than those from HBsAg(-). Our previous study found temporary positivity of HBsAg in infants from HBsAg(+) mothers. In this study, we hypothesized that HBsAg in infant blunt immune response to standard hepatitis B vaccination.
  
  
  METHODS
  A total of 328 consecutive HBsAg(+) mothers and their offspring were enrolled. Blood samples were taken from mothers and their infants and quantified for HBsAg, anti-HBs titer and HBV DNA load concentration; Placenta samples were collected to stain for HBsAg.
  
  
  RESULTS
  First, 6.7% infants (22/328) showed anti-HBs titer lower than 10 mIU/mL after HB vaccination (non-response to HB vaccine). HBsAg(+) newborns showed higher risk of non-response than HBsAg(-) infants (13.0% versus 5.0%, p = 0.016). Infants from high HBsAg titer mothers displayed higher risk of HBsAg positivity at birth than those from low titer mothers (45.3% versus 2.8%, p < 0.001). HBsAg titer in mothers of HBsAg(+) newborns was much higher than mothers of HBsAg(-) newborns (p < 0.001). All those data supported HBsAg can be transferred through placenta. Our hypothesis was further reinforced by immunostaining with specific antibody against HBsAg, a substantial higher prevalence (87.5% versus 30.8%, p = 0.024) and stronger immunostaining (p = 0.008) was demonstrated in HBsAg(+) group comparing with placenta of the HBsAg(-) group.
  
  
  CONCLUSIONS
  No response to HB vaccine in infants of HBsAg(+) mothers was associated to the transplacental transfer of HBsAg.
authors.affiliation: a The Department of Infectious Disease , First Affiliated Hospital of Medicine College, Xi'an Jiaotong University , Xi'an , Shaanxi , China.|b The Department of Rheumatism , First Affiliated Hospital of Medicine College, Xi'an Jiaotong University , Xi'an , Shaanxi , China.
authors.forename: Jing
authors.initials: J
authors.lastname: Wang
authors.affiliation: a The Department of Infectious Disease , First Affiliated Hospital of Medicine College, Xi'an Jiaotong University , Xi'an , Shaanxi , China.
authors.forename: Yingli
authors.initials: Y
authors.lastname: He
authors.affiliation: c The department of obstetrics , Shaanxi Kangfu Hospital , Xi'an , Shaanxi , China.
authors.forename: Dongfang
authors.initials: D
authors.lastname: Jin
authors.affiliation: a The Department of Infectious Disease , First Affiliated Hospital of Medicine College, Xi'an Jiaotong University , Xi'an , Shaanxi , China.
authors.forename: Jinfeng
authors.initials: J
authors.lastname: Liu
authors.affiliation: a The Department of Infectious Disease , First Affiliated Hospital of Medicine College, Xi'an Jiaotong University , Xi'an , Shaanxi , China.
authors.forename: Jie
authors.initials: J
authors.lastname: Zheng
authors.affiliation: d The department of obstetrics , The Second Affiliated Hospital of Shaanxi Traditional Chinese Medical College , Xianyang , Shaanxi , China.
authors.forename: Ningxia
authors.initials: N
authors.lastname: Yuan
authors.affiliation: e The department of obstetrics , Shangluo Central Hospital , Shangluo , Shaanxi , China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Bai
authors.affiliation: a The Department of Infectious Disease , First Affiliated Hospital of Medicine College, Xi'an Jiaotong University , Xi'an , Shaanxi , China.
authors.forename: Taotao
authors.initials: T
authors.lastname: Yan
authors.affiliation: a The Department of Infectious Disease , First Affiliated Hospital of Medicine College, Xi'an Jiaotong University , Xi'an , Shaanxi , China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Yang
authors.affiliation: f Institute of Neurobiology, Department of Human Anatomy and Histoembryology , Medicine College, Xi'an Jiaotong University , Xi'an , Shaanxi , China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Liu
authors.affiliation: a The Department of Infectious Disease , First Affiliated Hospital of Medicine College, Xi'an Jiaotong University , Xi'an , Shaanxi , China.
authors.forename: Shulin
authors.initials: S
authors.lastname: Zhang
authors.affiliation: a The Department of Infectious Disease , First Affiliated Hospital of Medicine College, Xi'an Jiaotong University , Xi'an , Shaanxi , China.
authors.forename: Yingren
authors.initials: Y
authors.lastname: Zhao
authors.affiliation: a The Department of Infectious Disease , First Affiliated Hospital of Medicine College, Xi'an Jiaotong University , Xi'an , Shaanxi , China.
authors.forename: Tianyan
authors.initials: T
authors.lastname: Chen
mesh_terms: D005260:Female; D006510:Hepatitis B Antibodies / Q000097:blood* / Q000276:immunology; D006514:Hepatitis B Surface Antigens / Q000097:blood*; D017325:Hepatitis B Vaccines / Q000276:immunology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008431:Maternal-Fetal Exchange / Q000276:immunology*; D011247:Pregnancy; D011446:Prospective Studies
chemical_list: D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens; D017325:Hepatitis B Vaccines
keywords: HBsAg; hepatitis B vaccine; immune response; placenta