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Failed Postnatal Immunoprophylaxis for Hepatitis B: Characteristics of Maternal Hepatitis B Virus as Risk Factors

1998; Oxford University Press; Volume: 27; Issue: 1 Linguagem: Inglês

10.1086/514610

1537-6591

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

Hepatitis Viruses Studies and Epidemiology

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., > or = 10(8) 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.