Jing Wang1,2, Yingli He1, Dongfang Jin3, Jinfeng Liu1, Jie Zheng1, Ningxia Yuan4, Yun Bai5, Taotao Yan1, Yuan Yang1, Yong Liu6, Shulin Zhang1, Yingren Zhao1, Tianyan Chen1. 1. a The Department of Infectious Disease , First Affiliated Hospital of Medicine College, Xi'an Jiaotong University , Xi'an , Shaanxi , China. 2. b The Department of Rheumatism , First Affiliated Hospital of Medicine College, Xi'an Jiaotong University , Xi'an , Shaanxi , China. 3. c The department of obstetrics , Shaanxi Kangfu Hospital , Xi'an , Shaanxi , China. 4. d The department of obstetrics , The Second Affiliated Hospital of Shaanxi Traditional Chinese Medical College , Xianyang , Shaanxi , China. 5. e The department of obstetrics , Shangluo Central Hospital , Shangluo , Shaanxi , China. 6. f Institute of Neurobiology, Department of Human Anatomy and Histoembryology , Medicine College, Xi'an Jiaotong University , Xi'an , Shaanxi , China.
Abstract
BACKGROUND: No or low hepatitis B (HB) vaccine response is more frequent in infants from HBsAg(+) mothers than those from HBsAg(-). Our previous study found temporary positivity of HBsAg in infants from HBsAg(+) mothers. In this study, we hypothesized that HBsAg in infant blunt immune response to standard hepatitis B vaccination. METHODS: A total of 328 consecutive HBsAg(+) mothers and their offspring were enrolled. Blood samples were taken from mothers and their infants and quantified for HBsAg, anti-HBs titer and HBV DNA load concentration; Placenta samples were collected to stain for HBsAg. RESULTS: First, 6.7% infants (22/328) showed anti-HBs titer lower than 10 mIU/mL after HB vaccination (non-response to HB vaccine). HBsAg(+) newborns showed higher risk of non-response than HBsAg(-) infants (13.0% versus 5.0%, p = 0.016). Infants from high HBsAg titer mothers displayed higher risk of HBsAg positivity at birth than those from low titer mothers (45.3% versus 2.8%, p < 0.001). HBsAg titer in mothers of HBsAg(+) newborns was much higher than mothers of HBsAg(-) newborns (p < 0.001). All those data supported HBsAg can be transferred through placenta. Our hypothesis was further reinforced by immunostaining with specific antibody against HBsAg, a substantial higher prevalence (87.5% versus 30.8%, p = 0.024) and stronger immunostaining (p = 0.008) was demonstrated in HBsAg(+) group comparing with placenta of the HBsAg(-) group. CONCLUSION: No response to HB vaccine in infants of HBsAg(+) mothers was associated to the transplacental transfer of HBsAg.
BACKGROUND: No or low hepatitis B (HB) vaccine response is more frequent in infants from HBsAg(+) mothers than those from HBsAg(-). Our previous study found temporary positivity of HBsAg in infants from HBsAg(+) mothers. In this study, we hypothesized that HBsAg in infant blunt immune response to standard hepatitis B vaccination. METHODS: A total of 328 consecutive HBsAg(+) mothers and their offspring were enrolled. Blood samples were taken from mothers and their infants and quantified for HBsAg, anti-HBs titer and HBV DNA load concentration; Placenta samples were collected to stain for HBsAg. RESULTS: First, 6.7% infants (22/328) showed anti-HBs titer lower than 10 mIU/mL after HB vaccination (non-response to HB vaccine). HBsAg(+) newborns showed higher risk of non-response than HBsAg(-) infants (13.0% versus 5.0%, p = 0.016). Infants from high HBsAg titer mothers displayed higher risk of HBsAg positivity at birth than those from low titer mothers (45.3% versus 2.8%, p < 0.001). HBsAg titer in mothers of HBsAg(+) newborns was much higher than mothers of HBsAg(-) newborns (p < 0.001). All those data supported HBsAg can be transferred through placenta. Our hypothesis was further reinforced by immunostaining with specific antibody against HBsAg, a substantial higher prevalence (87.5% versus 30.8%, p = 0.024) and stronger immunostaining (p = 0.008) was demonstrated in HBsAg(+) group comparing with placenta of the HBsAg(-) group. CONCLUSION: No response to HB vaccine in infants of HBsAg(+) mothers was associated to the transplacental transfer of HBsAg.
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Keywords:
HBsAg; hepatitis B vaccine; immune response; placenta