Maternal-Child Hepatitis B Virus Transmission in Singapore

Chan S H (WHO Immunology Centre, Faculty of Medicine, National University of Singapore, Sepoy Lines, Singapore 0316), Tan K L, Goh K T, Lim C, Tsakok M, Oon C J and Ratnam S S. Maternal-child hepatitis B virus transmission in Singapore. International Journal of Epidemiology 1985, 14: 173–177. A study of maternal-infant transmission of hepatitis B virus (HBV) was conducted in Singapore between June 1980 and June 1982. HBsAg carrier rate was highest among Chinese (6.2%) followed by Malay (2.3%) and Indian (0.6%) mothers. The presence of HBeAg in maternal sera correlated well with high titre HBsAg (p=7.34×10−5). Overall HBV transmission occurred in 27/56 (48.2%) infants from carrier mothers. The majority of the transmission was perinatal. There was a very strong correlation between transmission and HBeAg status of the mother (p=1.85×10−9; odds ratio=68.44) and to a lesser extent with high titre HBsAg (p=0.002; odds ratio =6.38). A strong negative correlation was seen between transmission and anti-HBeAg (p=8.19×10−7; odds ratio=0.04). At one year 19 (70.4%) infants were still HBsAg positive while seven (25.9%) lost the antigenemia and acquired anti-HBsAg and one developed HBsAg after one year. It could be calculated that perinatal HBV transmission contributed about 18% to the total pool of HBsAg positive infants of one year of age.