A predictive value of quantitative HBsAg for serum HBV DNA level among HBeAg-positive pregnant women

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• 作者：Kui-Xia Sun ; Jie Li ; Feng-Cai Zhu ; Jian-Xun Liu ; Rong-Cheng Li ; Xiang-Jun Zhai ; Yan-Ping Li ; Zhan-Jun Chang ; Jing-Jing Nie ; Hui Zhuang
• 关键词：HBsAg ; hepatitis B surface antigen ; HBV ; hepatitis B virus ; HBeAg ; hepatitis B e antigen ; HBIG ; hepatitis B immunoglobulin ; nPCR ; nested polymerase chain reaction ; ALT ; alanine aminotransferase ; CIMA ; chemiluminescence microparticles ; RLU ; relative light
• 刊名：Vaccine
• 出版年：2012
• 出版时间：3 August, 2012
• 年：2012
• 卷：30
• 期：36
• 页码：5335-5340
• 全文大小：404 K

文摘

Background

The high maternal HBV DNA level is the most important factor contributing to HBV perinatal transmission. This study is to explore whether HBsAg can be used as a surrogate marker of serum HBV DNA for HBsAg-positive pregnant women.

Methods

A total of 975 HBsAg-positive pregnant women and their infants were enrolled in this study. All infants received three doses of a yeast-derived recombinant Hepatitis B vaccine at 0, 1 and 6 months. They were also given Hepatitis B immunoglobulin (HBIG) at birth. HBsAg and HBeAg were determined using Abbott Architect assays while serum HBV DNA level was detected by the Abbott Real Time HBV DNA assay.

Results

Of the 975 subjects, 367 (37.6 % ) were HBeAg-positive and 608 (62.4 % ) were HBeAg-negative. Among the HBeAg-positive group, the samples with HBV DNA levels of ¡Ý7.0 log IU/mL were 76.6 % (281/367), and it was only 0.7 % (4/608) for the HBeAg-negative group. HBV DNA level was positively correlated with HBsAg in HBeAg-positive group (r = 0.786, p < 0.001) but not in HBeAg-negative group (r = 0.022, p = 0.593). Among HBeAg-positive group, the area under the receiver-operator curve (ROC) of HBsAg titer for high HBV DNA level (¡Ý7.0 log IU/mL) was 0.961 (95 % CI, 0.940-0.983, p < 0.001). The optimum cut-off point HBsAg titer above 4.1 log IU/mL had a sensitivity of 85.1 % , specificity of 96.5 % , and accuracy of 87.5 % to predict HBV DNA levels of ¡Ý7.0 log IU/mL. Of 367 infants born to mothers with HBeAg-positive, perinatal transmission was detected in 24 infants (6.5 % , 24/367). Their mothers all had serum HBV DNA levels of ¡Ý7.0 log IU/mL, 23 (95.8 % ) had HBsAg titers of ¡Ý4.1 log IU/mL and the other mother had HBsAg titer of 3.9 log IU/mL. Of 608 infants born to mothers with HBeAg-negative, only one (0.2 % , 1/608) became HBsAg-positive at the age of 7 months, and the mother of the infant had serum HBV DNA level of 3.4 log IU/mL and HBsAg titer of 1.8 log IU/mL, respectively.

Conclusion

Serum HBsAg titer may be used as a surrogate marker of serum HBV DNA for HBeAg-positive pregnant women.