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Maternal HBsAg comparable to viral load in predicting HBV in infants

Recent findings published in Hepatology showed that quantitative maternal hepatitis B surface antigen predicted chronic hepatitis B virus infection in infants at an accuracy similar to maternal viral load.

“Identifying and treating highly viremic mothers, whose infants are still at risk of infection despite immunoprophylaxis, is the crucial step to complete the last mile of hepatitis B eradication,” Wan-Hsin Wen, MD, professor of pediatrics at the Fu-Jen Catholic University College of Medicine in Taiwan, and colleagues wrote. “Our study shows that quantitative maternal HBsAg is highly correlated with maternal viral load, and infants born to mothers with high HBsAg levels are at substantial risk of infection.”

HBsAg has not been investigated in its ability to predict HBV infection in infants, the researchers wrote.

To determine whether mothers with high HBsAg were more likely to transmit HBV than mothers with high viral load, Wen and colleagues enrolled 526 mother and infant pairs with positive maternal HBsAg who were undergoing immunoprophylaxis. HBsAg and viral load were both measured during the peripartum period. Chronic infection was defined as HBsAg seropositivity for more than 6 months. In addition, chronic infection rates were estimated using multivariate logistic regression.

The researchers found that maternal HBsAg was positively correlated with maternal viral load (r = 0.69; P < .001). High maternal HBsAg level was significantly associated with risk for chronic HBV infection in the infant (OR = 15.02; 95% CI, 3.89-57.94). Further, the area under the curve for predicting infection by HBsAg was comparable to that of viral load (0.89 vs. 0.87).

“In addition to maternal viral load, quantitative maternal HBsAg can serve as an alternative marker to identify mothers at high risk for transmission and determine eligibility for treatment,” the researchers wrote. “Our results provide important information for the rational design of future screening and intervention strategies to further eliminate mother-to-infant HBV transmission.” – by Will Offit

Disclosures: The researchers report no relevant financial disclosures.