Abstract
BackgroundSerological testing for the presence of Hepatitis B Virus (HBV) markers and anti-HBs titers in infants born to HBsAg positive women is critically important for estimation in immunisation programme.MethodsThis was a multi-center and cross-sectional study conducted in Zhejiang province, China. Children aged 7 to 24 months born to HBsAg positive women during December 2018 to February 2019, completed additional HBV serological markers screening. We indicated distribution of HBV serological markers and anti-HBs titers in children. Multiple logistic regression model with adjusted odds ratio and 95% confidence interval (ORadj and 95% CI) was used to explore the factors associated with inadequate immune response (anti-HBs titers< 100 mIU/ml) among children.ResultsA total of 1849 children were included. Overall 25 children tested HBsAg positive, giving HBsAg positive rate of 1.35%(95%CI: 0.83-1.88%). 92.00% (23/25) HBsAg positive children were delivered by HBeAg positive mothers. The proportion of protective seroconversion (anti-HBs titers≥10mIU/ml) was 99.29% in all children, and 86.48% children were reported with adequate anti-HBs titers (≥100mIU/ml).We found a significant higher proportions of early antenatal health care (< 13 gestational weeks), and term birth in children with adequate response compared with inadequate response (all P < 0.05). Logistic regression showed preterm birth was a negative factor for inadequate anti-HBs titers (ORadj = 1.868,95%CI 1.132-3.085,P = 0.015).ConclusionsChildren delivered by HBeAg positive mothers had higher risk of vertical transmission of HBV, despite completion of 3 doses of hepatitis B vaccine and HBIG injection. Inadequate anti-HBs level was significantly associated with preterm birth in HBsAg positive women.
Highlights
Vertical transmission is the main route for young children to have Hepatitis B Virus (HBV) infection
All children completed three doses of hepatitis B vaccine, including 99.13%(1833) children with 10 μg/dose vaccine and 0.87%(16) without clear information on specific dose of vaccine.94.38% (1745) infants had their first dose of HBV vaccine within 6 h after birth, 2.33%(43) between and h, 2.70% (50) between and 24 h,0.11% (2) beyond24 hours after birth and 0.49% (9) without specific information
1824 children tested negative for Hepatitis B surface antigen (HBsAg). 25 children were HBsAg positive, giving overall HBsAg positive rate 1.35%. 92.00% (23/25) HBsAg positive children were born to Hepatitis B e antigen (HBeAg) positive women. 30.43%(7/23) of these HBeAg positive women received their first antenatal health care visit (ANC) beyond 13 gestational weeks
Summary
Vertical transmission is the main route for young children to have Hepatitis B Virus (HBV) infection. With the wide coverage of vaccination against HBV and Hepatitis. In some countries or regions, HBsAg positive rates in children at age five was even less than 1% [3, 5]. Some countries or regions in Africa and Asia still face high endemic of HBV, in women without vaccination [7, 8]. Less than 50% countries are available for providing first HBV vaccine dose within 24 h by WHO [2]. Serological testing for the presence of Hepatitis B Virus (HBV) markers and anti-HBs titers in infants born to HBsAg positive women is critically important for estimation in immunisation programme
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