• Woottichai Khamduang, Catherine Gaudy-Graffin, Nicole Ngo-Giang-Huong, Gonzague Jourdain, Alain Moreau, Thitiporn Borkird, Prapaisri Layangool, Nareerat Kamonpakorn, Weerachai Jitphiankha, Ratchanee Kwanchaipanich, Sathit Potchalongsin, Marc Lallemant, Wasna Sirirungsi, Alain Goudeau, and Program for HIV Prevention and Treatment (PHPT) group.
• Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand; INSERM U966, CHRU Tours, Faculté de Médecine, Université François-Rabelais, Tours, France; Institut de Recherche pour le Développement (IRD) UMI 174/Programs for HIV Prevention and Treatment (PHPT), Chiang Mai, Thailand.
• J. Clin. Virol. 2013 Oct 1; 58 (2): 415-21.

BackgroundDespite implementation of universal infant hepatitis B (HB) vaccination, mother-to-child transmission (MTCT) of hepatitis B virus (HBV) still occurs. Limited data are available on the residual MTCT of HBV in human immunodeficiency virus (HIV)-HBV co-infected women.ObjectivesWe assessed the prevalence of HBV infection among HIV-infected pregnant women and the rate of residual MTCT of HBV from HIV-HBV co-infected women and analyzed the viral determinants in mothers and their HBV-infected children.Study DesignHIV-1 infected pregnant women enrolled in two nationwide perinatal HIV prevention trials in Thailand were screened for HB surface antigen (HBsAg) and tested for HBeAg and HBV DNA load. Infants born to HBsAg-positive women had HBsAg and HBV DNA tested at 4-6 months. HBV diversity within each HBV-infected mother-infant pair was analyzed by direct sequencing of amplified HBsAg-encoding gene and cloning of amplified products.ResultsAmong 3312 HIV-1 infected pregnant women, 245 (7.4%) were HBsAg-positive, of whom 125 were HBeAg-positive. Of 230 evaluable infants born to HBsAg-positive women, 11 (4.8%) were found HBsAg and HBV DNA positive at 4-6 months; 8 were born to HBeAg-positive mothers. HBV genetic analysis was performed in 9 mother-infant pairs and showed that 5 infants were infected with maternal HBV variants harboring mutations within the HBsAg "a" determinant, and four were infected with wild-type HBV present in highly viremic mothers.ConclusionsHBV-MTCT still occurs when women have high HBV DNA load and/or are infected with HBV variants. Additional interventions targeting highly viremic women are thus needed to reduce further HBV-MTCT.Copyright © 2013 Elsevier B.V. All rights reserved.

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