Nina Weis1,2, Susan Cowan3, Sofie Hallager1, Sandra Dröse4, Lena Hagelskjær Kristensen5, Karin Grønbæk6, Janne Jensen7, Jan Gerstoft8, Lone G Madsen9, Mette Rye Clausen10, Suzanne Lunding11, Britta D Tarp12, Toke S Barfod13, Stine Sloth14, Dorte Kinggaard Holm15, Jesper Jensen1, Henrik Krarup16. 1. a Department of Infectious Diseases , Copenhagen University Hospital , Hvidovre , Denmark. 2. b Department of Clinical Medicine, Faculty of Health and Medical Sciences , University of Copenhagen , Copenhagen , Denmark. 3. c Department of Epidemiology , Statens Serum Institut , Copenhagen , Denmark. 4. d Department of Infectious Diseases , Odense University Hospital , Odense, Denmark. 5. e Department of Medicine , The Region Hospital , Viborg , Denmark. 6. f Department of Gastroenterology , Copenhagen University Hospital , Hvidovre , Denmark. 7. g Department of Medicine , Kolding Hospital , Denmark. 8. h Department of Infectious Diseases , Copenhagen University Hospital , Rigshospitalet , Denmark. 9. i Department of Medicine , Køge Hospital , Køge , Denmark. 10. j Department of Hepatology , Copenhagen University Hospital , Rigshospitalet , Denmark. 11. k Department of Infectious Diseases , Nordsjællands Hospital , Hillerød , Denmark. 12. l Diagnostic Center , Silkeborg Regional Hospital , Silkeborg , Denmark. 13. m Department of Infectious Diseases , Roskilde Hospital , Roskilde, Denmark. 14. n Department of Gastroenterology , Medical Section, Copenhagen University Hospital , Herlev , Denmark. 15. o Department of Clinical Immunology , Odense University Hospital , Odense , Denmark. 16. p Section of Molecular Diagnostics, Clinical Biochemistry and Department of Medical Gastroenterology , Aalborg University Hospital , Aalborg , Denmark.
Abstract
OBJECTIVE: In Denmark, pregnant women have been screened for hepatitis B virus (HBV) since 2005, and children born to HBV-infected mothers offered hepatitis B immunoglobulin at birth, vaccination against HBV at birth and after 1, 2 and 12 months. The purpose of this study was to determine the risk of vertical HBV transmission in children born to mothers with chronic HBV infection, to investigate the antibody response in the children and to investigate possible maternal predictive risk factors for HBV transmission. MATERIALS AND METHODS: Through the Danish Database for Hepatitis B and C, we identified 589 HBV-infected women who had given birth to 686 children, of whom 370 children were born to 322 women referred to hospital. 132 (36%) children, born to 109 mothers, were included in the study; 128 children had blood samples tested for HBsAg, anti-HBc (total), anti-HBs and HBV-DNA and four children had saliva samples tested for anti-HBc. RESULTS: We found vertical HBV transmission in Denmark to be 2.3% [95% CI: 0.5, 6.5], a high proportion of HBsAg-negative children with low levels of anti-HBs (18.4%) and a high proportion (15.2%) with resolved HBV infection. No maternal risk factor was statistically significantly associated with HBV vertical transmission. CONCLUSION: In a HBV low prevalence setting as Denmark, despite a national vaccination program, vertical HBV transmission occurred in 2.3% of children born to HBV-infected mothers. In addition, a high proportion of the children had insufficient anti-HBs levels and a high proportion had serological signs of resolved HBV infection.
OBJECTIVE: In Denmark, pregnant women have been screened for hepatitis B virus (HBV) since 2005, and children born to HBV-infected mothers offered hepatitis B immunoglobulin at birth, vaccination against HBV at birth and after 1, 2 and 12 months. The purpose of this study was to determine the risk of vertical HBV transmission in children born to mothers with chronic HBV infection, to investigate the antibody response in the children and to investigate possible maternal predictive risk factors for HBV transmission. MATERIALS AND METHODS: Through the Danish Database for Hepatitis B and C, we identified 589 HBV-infectedwomen who had given birth to 686 children, of whom 370 children were born to 322 women referred to hospital. 132 (36%) children, born to 109 mothers, were included in the study; 128 children had blood samples tested for HBsAg, anti-HBc (total), anti-HBs and HBV-DNA and four children had saliva samples tested for anti-HBc. RESULTS: We found vertical HBV transmission in Denmark to be 2.3% [95% CI: 0.5, 6.5], a high proportion of HBsAg-negative children with low levels of anti-HBs (18.4%) and a high proportion (15.2%) with resolved HBV infection. No maternal risk factor was statistically significantly associated with HBV vertical transmission. CONCLUSION: In a HBV low prevalence setting as Denmark, despite a national vaccination program, vertical HBV transmission occurred in 2.3% of children born to HBV-infected mothers. In addition, a high proportion of the children had insufficient anti-HBs levels and a high proportion had serological signs of resolved HBV infection.
Entities:
Keywords:
Hepatitis-viral; antibody response; hepatitis B virus infection; mother to child transmission; nationwide; resolved hepatitis B virus infection; vaccine; vertical transmission