Correlation between serum hepatitis B virus DNA load, status of hepatitis B e antigen and viral load in breast milk of hepatitis B virus-infected parturients

Abstract

Objective To study the correlation between hepatitis B virus (HBV) DNA load, hepatitis B e antigen (HBeAg) status and the viral load in breast milk of HBV-infected parturients. Methods A total of 370 HBV-infected parturients who delivered in the Second People′s Hospital of Tianjin between January 2010 and July 2013 were selected. Patients with hepatitis B surface antigen (HBsAg) positive, HBeAg (+ ) and hepatitis B core antibody (+ ) were put in HBeAg-positive group, those with HBsAg (+ ), hepatitis B e antibody (+ ) and hepatitis B core antibody (+ ) were included in HBeAg-negative group. HBV DNA levels in serum and breast milk within 24 hours postpartum were detected. Count data between groups were compared by chi-square test. Measurement data were compared by using t test. Correlation analysis was conducted by Pearson correlation analysis. Results 174 out of 370 parturients (47.0%) were included in HBeAg-positive group with serum HBV DNA load of (6.03 + 0.86) lg copies/mL. And 196 cases (53.0%) were included in HBeAg-negative group with serum HBV DNA (4.04 + 0.61) lg copies/mL. The difference between the two groups was statistically significant (t=25.883, P 1×105 copies/mL. Among them, 86 cases (72.9%) had HBV DNA>500 copies/mL in milk. The viral load in breast milk increased with that in serum. The comparison of detection rates of HBV DNA >1×105 - 1×107 copies/mL and>1×107 copies/mL in both HBeAg-positive and HBeAg-negative groups were both statistically significant (χ2=16.238 and 6.453, respectively, both P 1×105 - 1×107 copies/mL between HBeAg-positive group and HBeAg-negative group did not reach statistical significance (χ2=0.029, P=0.864). And there was no statistically significant differences between HBeAg-positive group and HBeAg-negative group for HBV DNA >1×107 copies/mL (χ2=0.002, P=0.965). Conclusions The transmission risk through breast milk in HBeAg-positive HBV-infected parturients is significantly higher than HBeAg-negative patients. HBV DNA load in breast milk depends on the viral load in serum. HBV DNA load in breast milk is not correlated with the status of HBeAg. Key words: Carry the maternal HBV; Hepatitis B e antigen; HBV DNA loads; Breast milk