Maternal Hepatitis B e Antigen can be an Indicator for Antiviral Prophylaxis of Perinatal Transmission of Hepatitis B Virus
Creators: name: Lu, Ying
name: Song, Yarong
name: Zhai, Xiangjun
name: Zhu, Fengcai
name: Liu, Jianxun
name: Chang, Zhanjun
name: Li, Yi
name: Xiao, Yiwei
name: Li, Lili
name: Liu, Minmin
name: Liu, Jia
name: Duan, Zhongping
name: Zou, Huaibin
name: Zhuang, Hui
name: Wang, Jie
name: Li, Jie
Publisher: name: Taylor & Francis
Year: 2021
Subjects: subject: Medicine
subject: Microbiology
subject: FOS: Biological sciences
subject: Cell Biology
subject: Biotechnology
subject: Chemical Sciences not elsewhere classified
subject: Immunology
subject: FOS: Clinical medicine
subject: Mathematical Sciences not elsewhere classified
subject: Infectious Diseases
subject: FOS: Health sciences
subject: Virology

description: As a high-risk factor of perinatal HBV transmission, the potential role of maternal hepatitis B e antigen (HBeAg) to guide antiviral prophylaxis has not yet been fully reported. This large prospective cohort study enrolled 1177 hepatitis B surface antigen (HBsAg)-positive pregnant women without antiviral treatment and their newborns. HBeAg, HBsAg, and viral load in maternal serum collected before delivery were measured. All the newborns were given standard passive-active immunoprophylaxis within 12h after birth, and post-vaccination serologic testing was performed at 7 (±7d) months of age. The results revealed that 20 of the 1177 infants (1.70%) were immunoprophylaxis failure, and all their mothers were HBeAg positive. Maternal quantitative HBeAg was positively correlated with viral load (r=0.83; <i>P</i>&lt;0.0001) and quantitative HBsAg (r=0.68; <i>P</i>&lt;0.0001). The area under the receiver operating characteristic curve (AUC) for predicting immunoprophylaxis failure by maternal HBeAg was comparable to that by maternal viral load (0.871 vs 0.893; <i>P</i>=0.441) and HBsAg (0.871 vs 0.871; <i>P</i>=0.965). The optimal cutoff value of maternal quantitative HBeAg to predict perinatal infection was 2.21 log<sub>10</sub> PEI U/mL, and the sensitivity and specificity was 100.0% and 74.5%, respectively. According to maternal viral load &gt;2×10<sup>5</sup> IU/mL, the sensitivity and specificity of maternal qualitative HBeAg to identify the risk of HBV MTCT for pregnant women and determine the necessity for antiviral prophylaxis was 95.5% and 92.6%, respectively. This study showed that maternal HBeAg can be a surrogate marker of HBV DNA for monitoring and evaluating whether antiviral prophylaxis is necessary for preventing perinatal HBV transmission. AASLD, American Association for the Study of Liver Diseases; AUC, area under the receiver operating characteristic curve; cccDNA, covalently closed circular DNA; CI, confidence interval; CMIA, chemiluminescent microparticle immunoassay; EASL, European Association for the Study of the Liver; HBeAg, hepatitis B e antigen; HBIG, hepatitis B immunoglobulin; HBsAg, hepatitis B surface antigen; HBV, hepatitis B virus; LMIC, low- and middle-income country; MTCT, mother-to-child transmission; PEI, Paul Ehrlich Institute; RDT, rapid diagnostic test; RLU, relative light unit; ROC, receiver operating characteristic; S/CO, sample to cut-off; WHO, World Health Organization.