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| |  HBeAg-Positive Pregnant Women With HBV DNA Warrant Further Assessment to Prevent Transmission to Infant: Presented at ICC By Louise Gagnon TORONTO -- June 23, 2009 -- Pregnant women who are at elevated risk of transmitting hepatitis B virus (HBV) to their unborn children should be referred to a specialist who can evaluate whether steps can be taken to reduce the potential for mother-to-child transmission, according to a study presented here at the 26th International Congress of Chemotherapy and Infection (ICC). Ameeta Singh, Division of Infectious Diseases, University of Alberta, Edmonton, Alberta, and colleagues retrospectively analysed factors linked to the transmission of HBV in infants born to mothers who tested positive for hepatitis B surface antigen (HBsAg) between 2000 and 2005 in Alberta, to determine which mothers were at greater risk of transmitting the virus to their children. Current intervention programs in Alberta offer postexposure prophylaxis to infants whose mothers have tested positive for HBV infection, explained Singh on June 20. "To prevent passage from the mother to the infant, the infants receive passive prophylaxis with hepatitis B immunoglobulin and 3 doses of vaccine given over several months to help them develop antibodies," said Singh. "[The treatment] is highly effective, but we do still see some failures. "The trouble is that, if we fail, 90% of those infants will go on to develop chronic hepatitis B, so they have it for life and are at much higher risk of developing cirrhosis and liver cancer," she continued. From provincial surveillance records, the researchers identified 12 cases of HBsAg-positive mothers (median age 30 years) with infants who were infected with HBV and 48 control subjects (median age 32 years) whose infants were not infected. The participants were tested for hepatitis e-antigen (HBeAg) and anti-hepatitis B core antigen (anti-HBc), and HBV DNA PCR sequencing was performed. HBeAg was positive in 7 of 9 cases (78%) and 12 control subjects (25%; P < .05). Anti-HBc was negative in 1 of 11 cases and positive in all control subjects. HBV DNA PCR was positive in all cases and 41 control subjects. No mothers tested positive for HIV or hepatitis C (HCV). Investigators found HBV vertical transmission was more common in HBeAg-positive mothers and in mothers who had higher HBV DNA levels. "The minimum recommendation should be that any mother who is HBeAg positive and who has any level of HBV DNA should be referred to a specialist for further assessment," said Singh. "We would ask mothers who are HBsAg positive to submit for DNA. The specialist would [decide] if they are suitable candidates for therapy." Funding for this study was provided by the Stollery Children's Hospital Foundation.
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