• Jun Li, Xiao-Qin Dong, Zhao Wu, An-Lin Ma, Shi-Bin Xie, Xu-Qing Zhang, Zhan-Qing Zhang, Da-Zhi Zhang, Wei-Feng Zhao, Guo Zhang, Jun Cheng, Qing Xie, Zhi-Qiang Zou, Ying-Xia Liu, Gui-Qiang Wang, Hong Zhao, and China Hepatitis B Related Fibrosis Assessment Research Group.
• Department of Infectious Diseases, Center for Liver Disease, Peking University First Hospital, Beijing 100034, China.
• Chin. Med. J. 2019 Nov 20; 132 (22): 2647-2656.

BackgroundFew data are available regarding the progression of liver disease and therapeutic efficacy in chronic hepatitis B virus (HBV) carriers infected by mother-to-child transmission (MTCT). This study aimed to investigate these two aspects by comparing the adult chronic HBV carriers in MTCT group with those in horizontal transmission group.MethodsThe 683 adult chronic HBV patients qualified for liver biopsy including 191 with MTCT and 492 with horizontal transmission entered the multi-center prospective study from October 2013 to May 2016. Biopsy results from 217 patients at baseline and 78 weeks post antiviral therapy were collected.ResultsPatients infected by MTCT were more likely to have e antigen positive (68.6% vs. 58.2%, χ = -2.491, P = 0.012) than those with horizontal transmission. However, in patients with MTCT, levels of alkaline phosphatase (ALP) (P = 0.031), Fibroscan (P = 0.013), N-terminal propeptide of Type III procollagen (PIIINP) (P = 0.014), and Laminin (LN) (P = 0.006) were high, in contrast to the patients with horizontal transmission for whom the levels of albumin (ALB) (P = 0.041), matrix metalloproteinase-3 (MMP-3) (P = 0.001) were high. The 47.2% of patients with MTCT and 36.8% of those with horizontal transmission had significant liver fibrosis (P = 0.013). Following antiviral therapy for 78 weeks, 21.2% and 38.0% patients with MTCT and horizontal transmission acquired hepatitis B e antigen (HBeAg) clearance, respectively (P = 0.043), and the virological response rates were 54.7% and 74.1% in the MTCT and horizontal groups, respectively (P = 0.005). MTCT was a risk factor for HBeAg clearance and virological response.ConclusionAdult patients with MTCT were more prone to severe liver diseases, and the therapeutic efficacy was relatively poor, which underlined the importance of earlier, long-term treatment and interrupting perinatal transmission.Trial RegistrationNCT01962155; https://clinicaltrials.gov.

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