433 QUANTIFICATION OF LARGE, MIDDLE AND SMALL HEPATITIS B VIRUS (HBV) SURFACE PROTEIN (HBsAg) FRACTIONS IN PATIENTS WITH ACUTE HEPATITIS B

S.B Wiegand,A Geipel,B Bremer,A Markova,C.M Bremer,M.P Manns,H Wedemeyer,D Glebe,M Cornberg

doi:10.1016/s0168-8278(13)60435-3

Abstract

Methods: 315 HBsAg positive mothers and their offspring received combined immunoprophylaxis (hepatitis B immune globulin and hepatitis B vaccine) were recruited in this study. The venous blood of 315 mothers and infants (315 at birth, 262 at 1-month-old and 251 at 7-month-old) was collected for tests of HBVDNA load and HBV markers titer. Result: The positive rates of HBVDNA, HBsAg and HBeAg in the newborns at birth were 17.8% (56/315), 25.1% (79/315) and 25.4% (80/315), respectively. Maternal HBVDNA load, HBsAg and HBeAg titer were associated with neonatal HBVDNA load, HBsAg and HBeAg titer at birth respectively. In the neonatus born to the pregnant mothers with HBVDNA>10 IU/ml, HBsAg>10 IU/ml and HBeAg>1 s/co, the probability of HBVDNA-, HBsAgand HBeAgpositive at birth significantly increased (areas under ORC curve were the largest, 0.770, 0.697 and 0.944, respectively). During the follow-up, the positive rates of HBVDNA, HBsAg and HBeAg in infants reduced gradually and HBVDNA (83.9%), HBsAg (87.3%) and HBeAg (87.5%) in the majority of infants turned to be negative at 7 months after birth, while 3.6% (9/251) infants became chronic HBV carriers (HBVDNAand HBsAg-positive from birth to 7-monthold) and 8.6% (18/242) were non-responders (anti-HBs <10mIU/ml at 7-month-old). High levels of HBsAg titer and HBVDNA load of newborns at birth were associated with chronic HBV infection, while the relevance between HBsAg, HBeAg and HBVDNA from mother to infant and the non-response to HB vaccination was uncertain. Conclusion: HBsAg and HBVDNA, as HBeAg, could cross the human placenta from mother to infant and lead to short-term antigenemia or virusemia in newborns, while HBsAgand HBVDNA-positive at birth may not be indication for HBV infection of infants. HBVDNA, HBsAg and HBeAg from mother to infant did not contribute to the non-response to HB vaccination, while further follow-up was still in need.

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