期刊
JOURNAL OF HEPATOLOGY
卷 60, 期 3, 页码 523-529出版社
ELSEVIER SCIENCE BV
DOI: 10.1016/j.jhep.2013.11.008
关键词
Mother-to-child transmission; Prevention; Immunoprophylaxis; HBV fetal infection; Amniocentesis
资金
- Beijing Ditan Hospital, Capital Medical University, Beijing, China [2008-008]
Background 82 Aims: Despite appropriate immunoprophylaxis, HBV vertical transmission (VI) occurs in 5-10% of infants born to HBs-antigen (HBsAg)+ mothers. We investigated whether amniocentesis increases the risk of transmission. Methods: We performed a case-control study on infants who were born to HBsAg+ mothers without antiviral exposure and completed appropriate immunization. Infants born to mothers with amniocentesis were compared to those without amniocentesis to assess VT rates, which were defined by the percentage of infants with HBsAg positivity when they were 7-12 months old. Results: Of the 642 consecutive infants enrolled, 63 infants with amniocentesis were compared with 198 matched infants selected from the remaining 579 infants without amniocentesis. There was a higher VT rate in infants with amniocentesis than in those without amniocentesis (6.35% vs. 2.53%; p = 0.226). Maternal HBV DNA levels before amniocentesis were further stratified to <500 copies/ml, 500-6.99 log(10) copies/ml, and >= 7 log(10) copies/ml for subset analyses. There were no significant differences in the VT rates between the amniocentesis group and the control group if the maternal HBV DNA levels were <6.99 log(10) copies/ml. However, a significantly higher VT rate was observed in the amniocentesis group vs. the control group if the maternal HBV DNA levels were >= 7 log(10) copies/ml (50% vs. 4.5%, respectively, p = 0.006). According to baseline value risk analyses, performing amniocentesis on highly viremic mothers was a risk factor for HBV transmission (OR = 21.3, 95% CI: 2.960-153.775). Conclusions: Amniocentesis performed on HBsAg+ mothers with HBV DNA >= 7 log(10) copies/ml significantly increased the frequency of VT. HBsAg+ women who plan to have amniocentesis should be evaluated for the risk of VT and stratified according to their HBV DNA levels. Further prospective studies are warranted to verify our findings. (C) 2013 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
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