1. Maternal hepatitis B e antigen can be an indicator for antiviral prophylaxis of perinatal transmission of hepatitis B virus.
- Author
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Lu Y, Song Y, Zhai X, Zhu F, Liu J, Chang Z, Li Y, Xiao Y, Li L, Liu M, Liu J, Duan Z, Zou H, Zhuang H, Wang J, and Li J
- Subjects
- Adolescent, Adult, Antiviral Agents therapeutic use, Area Under Curve, China epidemiology, DNA, Viral, Female, Hepatitis B epidemiology, Hepatitis B transmission, Hepatitis B virus genetics, Humans, Immunization, Passive, Immunotherapy, Active, Infectious Disease Transmission, Vertical prevention & control, Phylogeny, Pregnancy, Prognosis, Prospective Studies, Risk Factors, Serologic Tests, Viral Load, Young Adult, Hepatitis B prevention & control, Hepatitis B virology, Hepatitis B Surface Antigens blood, Hepatitis B e Antigens blood, Hepatitis B virus isolation & purification, Pregnancy Complications, Infectious virology
- Abstract
As a high-risk factor of perinatal HBV transmission, the potential role of maternal hepatitis B e antigen (HBeAg) to guide antiviral prophylaxis has not yet been fully reported. This large prospective cohort study enrolled 1177 hepatitis B surface antigen (HBsAg)-positive pregnant women without antiviral treatment and their newborns. HBeAg, HBsAg, and viral load in maternal serum collected before delivery were measured. All the newborns were given standard passive-active immunoprophylaxis within 12 h after birth, and post-vaccination serologic testing was performed at 7 (±7d) months of age. The results revealed that 20 of the 1177 infants (1.70%) were immunoprophylaxis failure, and all their mothers were HBeAg positive. Maternal quantitative HBeAg was positively correlated with viral load ( r = 0.83; P < .0001) and quantitative HBsAg ( r = 0.68; P < .0001). The area under the receiver operating characteristic curve (AUC) for predicting immunoprophylaxis failure by maternal HBeAg was comparable to that by maternal viral load (0.871 vs 0.893; P = .441) and HBsAg (0.871 vs 0.871; P = .965). The optimal cutoff value of maternal quantitative HBeAg to predict perinatal infection was 2.21 log
10 PEI U/mL, and the sensitivity and specificity was 100.0% and 74.5%, respectively. According to maternal viral load >2 × 105 IU/mL, the sensitivity and specificity of maternal qualitative HBeAg to identify the risk of HBV MTCT for pregnant women and determine the necessity for antiviral prophylaxis was 95.5% and 92.6%, respectively. This study showed that maternal HBeAg can be a surrogate marker of HBV DNA for monitoring and evaluating whether antiviral prophylaxis is necessary for preventing perinatal HBV transmission.- Published
- 2021
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