• Huey-Ling Chen, Lung-Huang Lin, Fu-Chang Hu, Jian-Te Lee, Wen-Terng Lin, Yao-Jung Yang, Fu-Chen Huang, Shu-Fen Wu, Solomon Chih-Cheng Chen, Wan-Hsin Wen, Chia-Hsiang Chu, Yen-Hsuan Ni, Hong-Yuan Hsu, Pei-Lin Tsai, Cheng-Lun Chiang, Ming-Kwang Shyu, Ping-Ing Lee, Feng-Yee Chang, and Mei-Hwei Chang.
• Department of Pediatrics, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan.
• Gastroenterology. 2012 Apr 1; 142 (4): 773-781.e2.

Background & AimsMother-to-infant transmission is the major cause of hepatitis B virus (HBV) infection among immunized children. There has been much debate about screening pregnant women and administering hepatitis B immunoglobulin (HBIG) to newborns. We analyzed the rate of HBV infection among children born to hepatitis B surface antigen (HBsAg)-positive mothers and whether HBIG administration reduces transmission.MethodsWe analyzed data from 2356 children born to HBsAg-positive mothers, identified through prenatal maternal screens. In addition to HBV vaccines, HBIG was given to all 583 children with hepatitis B e antigen (HBeAg)-positive mothers and to 723 of 1773 children with HBeAg-negative mothers. Serology tests for HBV were performed from 2007 to 2009, when children were 0.5-10 years old.ResultsA significantly greater percentage of children with HBeAg-positive mothers tested positive for antibodies against the hepatitis B core protein (16.76%) and HBsAg (9.26%) than children with HBeAg-negative mothers (1.58% and 0.29%, respectively; P < .0001 and <.001). Among the HBV-infected children, the rate of chronicity also was higher among children with HBeAg-positive mothers than children with HBeAg-negative mothers (54% vs 17%; P = .002). Similar rates of antibodies against the hepatitis B core protein (0.99% and 1.88%; P = .19) and HBsAg (0.14% and 0.29%; P = .65) were noted in children born to HBeAg-negative mothers who were or were not given HBIG. Infantile fulminant hepatitis developed in 1 of 1050 children who did not receive HBIG (.095%).ConclusionsChildren born to HBeAg-positive mothers are at greatest risk for chronic HBV infection (9.26%), despite immunization. Administration of HBIG to infants born to HBeAg-negative mothers did not appear to reduce the rate of chronic HBV infection, but might prevent infantile fulminant hepatitis. Screening pregnant women for HBsAg and HBeAg might control mother-to-infant transmission of HBV.Copyright © 2012 AGA Institute. Published by Elsevier Inc. All rights reserved.

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