Korean J Pediatr.  2007 Apr;50(4):348-354. 10.3345/kjp.2007.50.4.348.

The outcome of perinatal prophylaxis for HBeAg positive mothers according to the maternal HBV-DNA levels at the delivery time

• Jeong O
• Kim JH

• KMID: 2140829
• DOI: http://doi.org/10.3345/kjp.2007.50.4.348

Abstract

PURPOSE: Perinatal hepatitis B viral infection is decreasing; however, 10% of babies to HBeAg positive mothers still become chronic carriers despite perinatal prophylaxis. Although, the cause of prophylaxis failure is still unclear, an importance of maternal HBV-DNA level at the delivery time has been suggested. This study was established to certify if it would be a useful predictable factor for the outcome of perinatal prophylaxis.
METHODS
Twenty-nine HBeAg positive mothers whose babies had known outcomes of prophylaxis were selected. To determine the amount of maternal HBV-DNA, a quantitative PCR was performed with the WHO International Standard for HBV DNA NAT assays.
RESULTS
The mean logarithm HBV-DNA level of mothers with failed outcomes was significantly higher than that of mothers with succeessful outcomes (7.99 vs. 6.72, P=0.015). The predictable maternal HBV-DNA cut-off level to prophylaxis outcome was 2.83x10(7) copies/mL (100 pg/mL). None out of the case 16 (0%) who had below this level, and 5 out of 13 (38.5%) who had above this level of maternal HBV-DNA failed in perinatal prophylaxis.
CONCLUSIONS
Mothers with higher levels of HBV-DNA at delivery time would be prone to a worse outcome of prophylaxis using the conventional approach. Perinatal prophylaxis failure rate can be reduced, if we try to introduce more potent prophylactic treatment into the cases with this risk factor.

Keyword

Hepatitis B; Perinatal infection; Real time PCR; Maternal HBV-DNA; Prophylaxis failure

MeSH Terms

DNA
Hepatitis B
Hepatitis B e Antigens*
Humans
Mothers*
Polymerase Chain Reaction
Real-Time Polymerase Chain Reaction
Risk Factors
DNA
Hepatitis B e Antigens