Increased Protection of Earlier Use of Immunoprophylaxis in Preventing Perinatal Transmission of Hepatitis B Virus
| Autor: | Biao Xu, Mingjie Pan, Hongyu Huang, Lanhua Liu, Biyun Xu, Jie Chen, Chenyu Xu, Liping Chen, Jishi Yang, Yali Hu, Jing Feng, Yi-Hua Zhou, Yimin Dai, Tingmei Chen, Xiaoqin Zhu |
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| Rok vydání: | 2020 |
| Předmět: |
Microbiology (medical)
Hepatitis B virus HBsAg Pediatrics medicine.medical_specialty Hepatitis B immune globulin Hepatitis B vaccine Transmission (medicine) business.industry virus diseases Odds ratio medicine.disease_cause 03 medical and health sciences 0302 clinical medicine Infectious Diseases HBeAg medicine 030211 gastroenterology & hepatology 030212 general & internal medicine Risk factor business medicine.drug |
| Zdroj: | Clinical Infectious Diseases. 73:e3317-e3323 |
| ISSN: | 1537-6591 1058-4838 |
| Popis: | Background Passive-active immunoprophylaxis against mother-to-child transmission (MTCT) of hepatitis B virus (HBV) recommends administering hepatitis B immunoglobulin (HBIG) and birth-dose hepatitis B vaccine in infants within 12 or 24 hours after birth. With this protocol, MTCT of HBV still occurs in 5–10% infants of HBV-infected mothers with positive hepatitis B e antigen (HBeAg). The present study aimed to investigate whether earlier administration of HBIG and hepatitis B vaccine after birth can further increase protection efficacy. Methods We conducted a prospective, multi-center observational study in infants born to mothers with HBV infection, in whom neonatal HBIG and birth dose hepatitis B vaccine were administered within one hour after birth. The infants were followed up for HBV markers at 7–14 months of age. Results A total of 1140 pregnant women with HBV were enrolled, and 982 infants (9 twins) of 973 mothers were followed up at 9.6 ± 1.9 months of age. HBIG and birth-dose vaccine were administered in newborn infants within a median of 0.17 (0.02–1.0) hours after birth. The overall rate of MTCT was 0.9% (9/982), with none (0%) of the 607 infants of HBeAg-negative mothers and 9 (2.4%) of 375 infants of HBeAg-positive mothers acquiring HBV. All 9 HBV-infected infants were born to mothers with HBV DNA >2.75 × 106 IU/mL. Maternal HBV DNA levels >2 × 106 IU/mL were an independent risk factor (odds ratio, 10.627; 95% confidence interval, 2.135–∞) for immunoprophylaxis failure. Conclusions Earlier use (within 1 hour after birth) of HBIG and hepatitis B vaccine can provide better protection efficacy against MTCT of HBV. |
| Databáze: | OpenAIRE |
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