Q Zhu1, Q Lu, X Gu, H Xu, S Duan. 1. Children's Hospital, Shanghai Medical University, China.
Abstract
OBJECTIVE: The infection of Hepatitis B virus (HBV) in the uterus may occur in neonates born to HBV carrier mothers. The rates of intrauterine transmission in these neonates were 10%-16%, Recent studies on the methods of combined passive and active immunizations indicate an efficacy approaching 70%-90%, but intrauterine infection of HBV is the major cause of failure of vaccination to combat hepatitis B in neonates born to HBV carrier mothers. We studied the interruptive effect of HBV specific immunoglobulin (HBIG) before delivery in the prevention of intrauterine transmission of HBV. METHODS: Of 3632 pregnant women, two hundred and four were HBV carriers; they were randomly divided into an HBIG group and a control group. Each subject in the HBIG group received 200 IU of HBIG intramuscularly at 3, 2 and 1 month before delivery. The subjects in the control group did not receive any specific treatment. Blood tests were conducted for all the subjects and their neonates after birth. Blood specimens were tested for HBsAg and HBeAg by enzyme immunoassay (Abbott Kits). RESULTS: The results showed that the rates of intrauterine transmission in the two groups were 5.7% and 14.7% respectively (X2 = 4.58 P < 0.05). No significant differences were observed for the positive rates of HBsAg and HBeAg between the two groups after delivery, but titer of HBsAg was reduced significantly in the HBIG group (t = 4.82, P < 0.01). CONCLUSIONS: Our study suggests that HBV infection in the uterus may be interrupted using multiple HBIG intramuscularly before delivery without any side effects.
RCT Entities:
OBJECTIVE: The infection of Hepatitis B virus (HBV) in the uterus may occur in neonates born to HBV carrier mothers. The rates of intrauterine transmission in these neonates were 10%-16%, Recent studies on the methods of combined passive and active immunizations indicate an efficacy approaching 70%-90%, but intrauterine infection of HBV is the major cause of failure of vaccination to combat hepatitis B in neonates born to HBV carrier mothers. We studied the interruptive effect of HBV specific immunoglobulin (HBIG) before delivery in the prevention of intrauterine transmission of HBV. METHODS: Of 3632 pregnant women, two hundred and four were HBV carriers; they were randomly divided into an HBIG group and a control group. Each subject in the HBIG group received 200 IU of HBIG intramuscularly at 3, 2 and 1 month before delivery. The subjects in the control group did not receive any specific treatment. Blood tests were conducted for all the subjects and their neonates after birth. Blood specimens were tested for HBsAg and HBeAg by enzyme immunoassay (Abbott Kits). RESULTS: The results showed that the rates of intrauterine transmission in the two groups were 5.7% and 14.7% respectively (X2 = 4.58 P < 0.05). No significant differences were observed for the positive rates of HBsAg and HBeAg between the two groups after delivery, but titer of HBsAg was reduced significantly in the HBIG group (t = 4.82, P < 0.01). CONCLUSIONS: Our study suggests that HBV infection in the uterus may be interrupted using multiple HBIG intramuscularly before delivery without any side effects.
Authors: Ai Kubo; Lyle Shlager; Amy R Marks; Dena Lakritz; Colette Beaumont; Kim Gabellini; Douglas A Corley Journal: Ann Intern Med Date: 2014-06-17 Impact factor: 25.391