Failed postnatal immunoprophylaxis for hepatitis B: Characteristics of maternal hepatitis B virus as risk factors

Siew Lin Ngui, Nicholas Andrews, G. S. Underhill, J. Heptonstall, C. G. Teo

Research output: Contribution to journalArticlepeer-review

100 Citations (Scopus)

Abstract

A retrospective case-control study was conducted to determine why some infants born full-term without obstetric intervention to hepatitis B e antigen (HBeAg)-seropositive mothers become infected by hepatitis B virus (HBV) despite having received passive-active immunoprophylaxis. Cases and controls comprised 12 hepatitis B surface antigen (HBsAg)-seropositive infants and 22 HBsAg-seronegative infants, respectively. Infants infected by putative vaccine-escape mutants were excluded. Risk factors, after adjustment for the level of maternal viremia, were the following allelic base changes in maternal HBV:C158, A328, G365, and A479 (P = .017, .005, .003, and .005, respectively). High-level maternal viremia (i.e.≤108 genome equivalents/mL) was a significant factor only after adjustment for G365 (P = .027). HBV DNA sequences recovered from one of the cases, the case's mother, and three infected contacts all had the high-risk mutations. Specific allelic mutations in maternal HBV and level of maternal viremia are potential predictors of vertical breakthrough infection.

Original languageEnglish
Pages (from-to)100-106
Number of pages7
JournalClinical Infectious Diseases
Volume27
Issue number1
DOIs
Publication statusPublished - 1998

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