Efficacy of two injections of hepatitis B immunoglobulin in infants to interrupt mother-to-children transmission of hepatitis B virus
10.3760/cma.j.issn.1003-9279.2017.02.013
- VernacularTitle: 新生儿出生后两次乙肝免疫球蛋白注射不提高HBV母婴传播阻断效果
- Author:
Ying ZHANG
1
;
Wei YI
2
;
Minghui LI
3
;
Dan ZHANG
3
;
Luxue ZHANG
3
;
Yuhong HU
2
;
Min LIU
2
;
Shunai LIU
3
;
Wenhao HUA
3
;
Shujing SONG
3
;
Gan WAN
3
;
Yao XIE
1
Author Information
1. Peking University Ditan Teaching Hospital, Beijing 100015, China
2. Department of Obstetrics and Gynecology, Beijing Ditan Hospital, Capital Medical University, Beijing100015, China
3. Liver Diseases Center, Beijing Ditan Hospital, Capital Medical University, Beijing100015, China
- Publication Type:Journal Article
- Keywords:
Hepatitis B immunoglobulin;
HBV;
Hepatitis B vaccine;
Mother-to-child transmission
- From:
Chinese Journal of Experimental and Clinical Virology
2017;31(2):142-147
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the efficacy of 200IU hepatitis B immunoglobulin (HBIG) injection at 1 month after birth to interrupt the mother-to-children transmission (MTCT) of hepatitis B virus (HBV).
Methods:Infants born to mothers who were hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) positive, with HBV DNA load ≥1.0×106 IU/ml and who did not receive antiviral drug treatment during pregnancy, were randomly divided into 2 groups. Infants in the control group were treated with standard immunoprophylaxis: 200 IU HBIG and 10 μg recombinant hepatitis B vaccine injection within 2 h after birth and a vaccine booster at 1 and 6 months after birth. For infants in the HBIG group the standard immunoprophylaxis and an additional 200 IU HBIG were administered at 1 month. HBsAg, the antibody to HBsAg (anti-HBs), and HBV DNA load were measured at birth and after 7 months. later.Immunoprophylaxis failure was defined as the presence of HBV DNA and HBsAg positivity or the presence of HBV DNA and HBsAg negativity at 7 months.
Results:In this prospective cohort study, of the 280 infants enrolled, 14 infants (HBIG/control: 6/8) were lost to follow-up and 266 subjects (HBIG/control: 134/132) completed the 7-month study. The log10HBV DNA load of mothers in the HBIG group and control group were (7.31±0.66) log10IU/ml and (7.32±0.74) log10IU/ml, respectively (P=0.92). The MTCT rate of the two groups was similar (5.97% vs. 7.58%, P=0.63). At 7 months, the HBsAg positive rate and the level of anti-HBs in the two groups were 94.03%(126/134)vs. 91.67% (121/132) and 623.60±412.93 mIU/mL vs. 620.38±399.10 mIU/ml, respectively with no significant difference (P=0.48 and P=0.95, respectively). The log10 HBV DNA load of mothers in immunoprophylaxis failure group and success group was similar (P=0.09). The number of infants who were serum HBsAg positive and HBV DNA positive at birth in the immunoprophylaxis failure group were higher than those in the success group (100% and 100% vs. 35.89% and 31.85%, P<0.01, respectively). The serum HBsAg levels in infants at birth was the only independent relevant factor for HBV MTCT, with risk rates of 11.18 (95% Confidence interval (CI), 1.23-101.88), 352.00 (95%CI, 15.82-7833.20), and 968.00 (95%CI 81.35-11519.19) for HBsAg levels of 0.05-< 1, 1-< 10, and ≥ 10 IU/ml, respectively, compared to infants with HBsAg levels < 0.05 IU/ml.
Conclusions:Administering 200IU HBIG injection at 1 month did not reduce the risk of HBV MTCT.
