Outcome of Infants Born to Women with Chronic Hepatitis B: A Local Risk-Based Strategy in a Low Prevalence Country

Background Chronic hepatitis-B virus (HBV) infection due to mother-to-child transmission (MTCT) during the perinatal period is an important global health concern. Chile is a low-prevalence country with an increasing migratory inflow from Latin- American countries, with intermediate to high endemic rates of HBV infection, and until 2021, there is no universal maternal screening. This study aimed to evaluate infant outcomes using a risk-based strategy of maternal screening to prevent MTCT of hepatitis B virus (HBV) in a low-prevalence country. Methods This prospective study included infants born to HBsAg-positive women detected using a local risk-based strategy. The exposed infants received immunoprophylaxis (IP) and follow-up to evaluate their clinical outcomes and immune responses through post-serological vaccine testing (PSVT) after completing the three- dose schedule of the HBV vaccine. Results A total of 99 HBsAg-positive mothers were detected. Seventy-six (82%) infants completed the follow-up and had PSVT between 9 and 12 months of age. 55.2% female, the median gestational age was 39 weeks (25–41) and the median birth weight was 3,130g (816–4,400 g). All patients received IP with recombinant HBV vaccine plus hepatitis-B virus immunoglobulin (HBIG) and three doses of the HBV vaccine. There were no cases of HBV infection, and 96% (72) responded to immunization with HBsAg antibodies (anti-HBsAg) >10 UI/ml, with a median level of 799 IU/ml. Conclusions A high-risk strategy can be implemented in countries with non-universal screening for VHB. Timely IP plus high-uptake VHB vaccination in infants born to HBsAg-positive mothers was associated with a high immunogenic response and absence of MTCT..

What’s it’s already known on this subject? There is robust evidence that immunoprophylaxis is recommended in all infants born to a HBsAg positive mother like one of different strategies to control VHBtransmission. What this study adds? In countries with non-universal screening of VHB a risk based strategy could be considered to prevent MTCT. Timely immunoprophylaxis plus high uptake VHB vaccination in infants born to HBsAg positive mothers is associated with a high immunogenic response and no MTCT. PVST should be considered in populations with lower immunogenic response such as infants born with <2,000 g of weight. PVST should be performed 1 or 2 months after the priming vaccine doses, helping to avoid unnecessary revaccination due to expected declining seroprotecting levels through time..

Medienart:	E-Artikel

Erscheinungsjahr:	2024
Erschienen:	2024

Enthalten in:	Zur Gesamtaufnahme - volume:28
Enthalten in:	Maternal and child health journal - 28(2024), 4 vom: 15. Feb., Seite 767-774

Sprache:	Englisch

Beteiligte Personen:	Copiz, Giannina Izquierdo [VerfasserIn] Ibañez, Carolina [VerfasserIn] Piñera, Cecilia [VerfasserIn] Cordova, Luis [VerfasserIn] Payá, Ernesto [VerfasserIn] Leal, Paula [VerfasserIn] Villena, Rodolfo [VerfasserIn]

Links:	Volltext [lizenzpflichtig]

BKL:	44.67
Themen:	Hepatitis B Immunogenicity Mother to child transmission Post-vaccination serologic testing Screening

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© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

doi:	10.1007/s10995-024-03909-3

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PPN (Katalog-ID):	SPR055287433