Journal Article

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

S. L. Ngui, N. J. Andrews, G. S. Underhill, J. Heptonstall and C. G. Teo

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 27, issue 1, pages 100-106
Published in print July 1998 | ISSN: 1058-4838
Published online July 1998 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/514610
Failed Postnatal Immunoprophylaxis for Hepatitis B: Characteristics of Maternal Hepatitis B Virus as Risk Factors

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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., ⩾108 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.

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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