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Presence of Hepatitis B Virus Markers in Umbilical Cord Blood: Exposure to or Infection with the Virus?

31 Pages Posted: 25 Sep 2018

See all articles by Jingli Liu

Jingli Liu

Nanjing University - Jiangsu Key Laboratory of Molecular Medicine

Biao Xu

Nanjing University

Tingmei Chen

Zhenjiang Fourth People’s Hospital

Jie Chen

Nanjing University

Jing Feng

Nanjing University - Drum Tower Hospital, Department of Obstetrics and Gynecology

Chenyu Xu

Zhenjiang Fourth People’s Hospital

Lanhua Liu

Taixing People’s Hospital

Yali Hu

Nanjing University

Yi-Hua Zhou

Nanjing University - Jiangsu Key Laboratory for Molecular Medicine; Nanjing University - Department of Biostatistics; Nanjing University - Department of Laboratory Medicine and Infectious Diseases

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Abstract

Background: Failure of immunoprophylaxis in the prevention of mother-to-infant transmission of hepatitis B virus (HBV) is usually attributed to in uterine infection. We aimed to clarify whether the presence of HBV markers in cord blood indicates exposure to or infection with HBV.

Methods: We prospectively recruited hepatitis B surface antigen (HBsAg)-positive pregnant women and their neonates 2012 through 2015. All neonates received passive-active immunoprophylaxis after birth. The infants were followed up at 7-14 months of age.

Findings: Totally 329 HBsAg-positive pregnant women and 333 neonates were enrolled. No cord blood was anti-HBc IgM positive. Of the neonates, 290 (87.1%) were followed up and 6 (2.1%) were infected with HBV. Of 146 neonates born to hepatitis B e antigen (HBeAg)-negative mothers, 38 (26.0%) and 30 (20.5%) had detectable HBsAg and HBV DNA in cord blood respectively, but none of 126 infants followed up was infected. Of 187 neonates born to HBeAg-positive mothers, 92 (49.2%) and 79 (42.2%) had detectable HBsAg and HBV DNA respectively; 6 (3.7%) of 164 infants followed up were infected. Of seven neonates with HBV DNA >10^5 IU/ml in cord blood, four had no infection and three others were infected.

Interpretation: Presence of HBsAg and/or HBV DNA, even at high levels, in cord blood just indicates exposure to, but not infection with HBV. Presence of HBV markers in cord blood cannot define intrauterine infection.

Funding: This work was supported by the Jiangsu Provincial Department of Health (H201537), the Science and Technology Department of Jiangsu Province (BK20161105), and the National Natural Science Foundation of China (81672002), China.

Declaration of Interest: The authors have no conflict of interest to disclose.

Ethical Approval: This study was approved by the institutional review board of each hospital. All methods were performed in accordance with the protocols set up based on the relevant guidelines and regulations. Written informed consent was obtained from each pregnant woman; the infant’s consent was assigned by his/her mother.

Keywords: hepatitis B virus; cord blood; HBV DNA; anti-HBc IgM; intrauterine infection

Suggested Citation

Liu, Jingli and Xu, Biao and Chen, Tingmei and Chen, Jie and Feng, Jing and Xu, Chenyu and Liu, Lanhua and Hu, Yali and Zhou, Yi-Hua, Presence of Hepatitis B Virus Markers in Umbilical Cord Blood: Exposure to or Infection with the Virus? (August 19, 2018). Available at SSRN: https://ssrn.com/abstract=3235627 or http://dx.doi.org/10.2139/ssrn.3235627

Jingli Liu

Nanjing University - Jiangsu Key Laboratory of Molecular Medicine

Nanjing, 210093
China

Biao Xu

Nanjing University ( email )

Nanjing, Jiangsu 210093
China

Tingmei Chen

Zhenjiang Fourth People’s Hospital

Zhenjiang
China

Jie Chen

Nanjing University ( email )

Nanjing, Jiangsu 210093
China

Jing Feng

Nanjing University - Drum Tower Hospital, Department of Obstetrics and Gynecology

321 Zhong Shan Road
Nanjing, Jiangning District 210008
China

Chenyu Xu

Zhenjiang Fourth People’s Hospital

Zhenjiang
China

Lanhua Liu

Taixing People’s Hospital

Taixing
China

Yali Hu

Nanjing University

Nanjing, Jiangsu 210093
China

Yi-Hua Zhou (Contact Author)

Nanjing University - Jiangsu Key Laboratory for Molecular Medicine ( email )

China

Nanjing University - Department of Biostatistics ( email )

China

Nanjing University - Department of Laboratory Medicine and Infectious Diseases ( email )

Nanjing
China