| Perinatal transmission of hepatitis B virus: an Australian experience. | |
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MedLine Citation:
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PMID: 19413519 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To determine the rate of perinatal hepatitis B virus (HBV) transmission in an Australian setting and to identify maternal virological factors associated with highest risk of transmission. DESIGN, PARTICIPANTS AND SETTING: A prospective, observational study of perinatal transmission of HBV. Participants were pregnant women attending Sydney South West Area Health Service antenatal clinics who tested positive for hepatitis B surface antigen (HBsAg), and their babies. All babies were routinely offered hepatitis B immunoglobulin (HBIG) and HBV vaccination. Babies positive for HBsAg at 9-month follow-up underwent further virological testing, including HBV DNA sequencing. The study was conducted between August 2002 and May 2008. MAIN OUTCOME MEASURES: HBV DNA levels and demographic characteristics of HBsAg-positive pregnant women; proportion of their infants with active HBV infection at 9-month follow-up; maternal characteristics affecting transmission rate; HBV DNA sequencing of infected infants and their mothers. RESULTS: Of 313 HBsAg-positive pregnant women, 213 (68%) were HBV DNA-positive and 92 (29%) were positive for hepatitis B "e" antigen (HBeAg); 138 babies born to HBV DNA-positive mothers were tested for HBV infection (HBsAg positivity) at about 9 months of age. Four cases of transmission were identified. All four mothers had very high HBV DNA levels (> 10(8) copies/mL) and were HBeAg-positive. Three of the four infants were infected with wild-type HBV strains, with identical maternal/infant isolates. The fourth mother-infant pair had an S gene variant, HBV D144E, which has been previously reported in association with vaccine/HBIG escape. (Unfortunately, HBIG was inadvertently omitted from the immunisation schedule of this infant.) Transmission rates were 4/138 (3%) from HBV DNA-positive mothers overall, 4/61 (7%) from HBeAg-positive mothers, and 4/47 (9%) from mothers with very high HBV DNA levels. No transmission was seen in 91 babies of mothers with HBV DNA levels < 10(8) copies/mL. CONCLUSION: In this cohort, HBV perinatal transmission was restricted to HBeAg-positive mothers with very high viral loads. |
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Authors:
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Elke Wiseman; Melissa A Fraser; Sally Holden; Anne Glass; Bronwynne L Kidson; Leon G Heron; Michael W Maley; Anna Ayres; Stephen A Locarnini; Miriam T Levy |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: The Medical journal of Australia Volume: 190 ISSN: 0025-729X ISO Abbreviation: Med. J. Aust. Publication Date: 2009 May |
Date Detail:
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Created Date: 2009-05-05 Completed Date: 2009-06-25 Revised Date: 2009-10-22 |
Medline Journal Info:
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Nlm Unique ID: 0400714 Medline TA: Med J Aust Country: Australia |
Other Details:
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Languages: eng Pagination: 489-92 Citation Subset: IM |
Affiliation:
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Liverpool Hospital, Sydney South West Area Health Service, Sydney, NSW, Australia. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Australia / epidemiology DNA, Viral / blood Female Hepatitis B / blood, epidemiology, transmission* Hepatitis B Surface Antigens / blood Hepatitis B e Antigens / blood Hepatitis B virus / genetics Humans Infant, Newborn Infectious Disease Transmission, Vertical / statistics & numerical data* Pregnancy Pregnancy Complications, Infectious / blood, epidemiology* Viral Load |
| Chemical | |
Reg. No./Substance:
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0/DNA, Viral; 0/Hepatitis B Surface Antigens; 0/Hepatitis B e Antigens |
| Comments/Corrections | |
Comment In:
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Med J Aust. 2009 Sep 21;191(6):357; author reply 357
[PMID:
19769564
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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