Identification of risk factors associated with immunoprophylaxis failure to prevent the vertical transmission of hepatitis B virus.

OBJECTIVE

To determine the potential risk factors associated with the immunoprophylaxis failure to prevent hepatitis B virus (HBV) vertical transmission.

METHODS

A total of 1360 newborn infants from HBsAg(+) women were included. Some pregnant women were vaccinated with anti-HBs immunoglobulins (HBIG) monthly for three months beginning at 7 months post pregnancy. All newborns received HBIG injection immediately after birth and were vaccinated with recombinant hepatitis B vaccine. Neonates were followed up for one year and their HBV-related parameters were tested longitudinally.

RESULTS

There were 21 cases (1.54%) with immunoprophylaxis failure (HBsAg(+) and/or HBV DNA(+) in 12-month old). Infants with immunoprophylaxis failure were associated with HBeAg(+) or HBV DNA(+) in their mother, particularly for those with high titers (≥10(7) IU/ml) of HBV DNA. The HBV vertical transmission rates in those infants were associated with feeding modes, but not with the HBIG vaccination in their mothers or delivery method of these babies. Serum HBeAg(+) (RR, 31.740; 95%CI, 3.884-259.381; p < 0.001) and HBV DNA ≥10(7) IU/ml in pregnant women (RR, 22.583; 95%CI, 4.749-107.397; p < 0.000) after adjusted other tested factors were independent risk factors of the immunoprophylaxis failure in infants.

CONCLUSIONS

Our results suggest that maternal serum HBeAg(+) and high HBV load are potential predictors of immunoprophylaxis failure to prevent HBV vertical transmission.