Study on a combined antepartum and postpartum to interrupt the transmission of hepatitis B virus from mother with both positive HBsAg and HBeAg to infant

Objective The infants born to hepatitis B virus (HBV) carrier mothers are the high risk children who are susceptible to HBV infection. About ten years of studies show that hepatitis B virus vaccine plus hepatitis B immunoglobulin (HBIG) inoculation can interrupt mother to infant transmission, which has been generally accepted. About 70%～90% children can be protected by this way. Intrauterine HBV infection is responsible for most of the immunoprophylaxis failure, so we study on a combined antepartum with postpartum to interrupt transmission of HBV from HBsAg positive and HBeAg positive mothers to their infants. Methods HBV carrier mothers, whose HBsAg and HBeAg were both positive, and later their infants were randomly divided into two groups. The gravidas in group 1 received 400 IU HBIG every four week (from pregnancy for 28 week to delivery); the gravidas in group 2 didn't receive any HBIG (the control group). After delivery, all the infants in both groups were given 2 dose of 200 IU HBIG at birth and at 15 days, then accepted 3 dose of HBV vaccine at 1, 2 and 7 months. These infants were periodically followed up until 1 year of age and their sera were obtained to test HBV markers. 104 mothers and their 105 infants were followed for 12 months. Results There were 51 infants in group 1 and 54 infants in group 2. In group 1, the rate of intrauterine HBV infection was 5.9%, and at 12 month old, the rate of chronic HBV infection was 5.9% and the rate of infants with the protective level against HBV infection was 94.1%. In group 2, the rate of intrauterine HBV infection was 18.5%, and at 12 month old, the rate of chronic HBV infection was 16.7% and the rate of infants with the protective level against HBV infection was 83.3%. χ 2 test was used to compare the different rates of intrauterine HBV infection between the two groups (χ 2=3.86, P 0.05). Conclusions More than 94% high risk infants, who were born to HBsAg positive and HBeAg positive carrier mothers, were protected by the antepartum with postpartum of immunoprophylaxis, which can significantly interrupt the transmission of HBV from mothers with both positive HBsAg and HBeAg to their infants.