Sellier Pierre, Maylin Sarah, Amarsy Rishma, Mazeron Marie-Christine, Larrouy Lucile, Haïm-Boukobza Stéphanie, Lopes Amanda, Moreno Maria-Dolores, Ricbourg Aude, Simoneau Guy, Magnier Jean-Dominique, Mercier-Delarue Sophie, Delcey Véronique, Evans John, Cambau Emmanuelle, Barranger Emmanuel, Simon François, Bergmann Jean-François
Service de Médecine Interne A (Pr J.F. Bergmann), Hôpital Lariboisière, Paris, France.
Liver Int. 2015 Feb;35(2):409-16. doi: 10.1111/liv.12561. Epub 2014 Apr 28.
BACKGROUND & AIMS: Mother-to-child (MTC) hepatitis B virus (HBV) transmission has been mainly studied in Asia. The geographical origins of women and HBV genotypes differ in Europe. The aims were to determine the rate and risk factors of MTC HBV transmission from women with high HBV DNA loads in a maternity hospital in Paris, France.
Retrospective study of HIV-negative, HBs Ag-positive pregnant women with HBV DNA loads above 5 Log10 I.U/ml who were not given lamivudine or tenofovirDF during pregnancy between 2004 and 2011.
Among 11 417 pregnant women, 437 (4%) showed a positive HBs Ag. Among these women, 52 had HBV DNA loads above 5 Log10 I.U/ml: 41, 10 and 1 born in Asia, sub-Saharan Africa and Europe respectively. Among the 52 women, 40 were eligible for the analysis: no antiviral therapy during pregnancy; children over 9 months old. Twenty-eight (70%) women were assessed, corresponding to 41 childbirths. Eleven children (27%) had positive HBs Ag, 14 (34%) had positive HBc and HBs Ab, 16 (39%) had positive HBs Ab only. The risk of having positive HBs Ag, according to maternal HBV DNA loads, was 14% for HBV DNA loads less or equal to 8 Log10 I.U/ml, 42% for HBV DNA loads over 8 Log10 I.U/ml, P = 0.04, but not related to the women's origin, HBV genotype.
This study confirms that serovaccination does not fully protect newborns from MTC HBV transmission, when maternal HBV DNA loads exceed 5 Log10 I.U/ml, regardless of the women's origin or HBV genotype.
母婴传播乙肝病毒（HBV）的研究主要集中在亚洲。欧洲女性及其HBV基因型的地理来源有所不同。本研究旨在确定法国巴黎一家妇产医院中，高HBV DNA载量女性母婴传播HBV的发生率及危险因素。
对2004年至2011年间在孕期未接受拉米夫定或替诺福韦酯治疗、HIV阴性、HBsAg阳性且HBV DNA载量高于5 Log10 I.U/ml的孕妇进行回顾性研究。
在11417名孕妇中，437名（4%）HBsAg呈阳性。在这些女性中，52名HBV DNA载量高于5 Log10 I.U/ml，其中分别有41名、10名和1名出生于亚洲、撒哈拉以南非洲和欧洲。在这52名女性中，40名符合分析条件：孕期未接受抗病毒治疗；孩子年龄超过9个月。对28名（70%）女性进行了评估，共涉及41次分娩。11名儿童（27%）HBsAg呈阳性，14名（34%）HBc和HBsAb呈阳性，16名（39%）仅HBsAb呈阳性。根据母亲的HBV DNA载量，HBV DNA载量小于或等于8 Log10 I.U/ml时，婴儿HBsAg呈阳性的风险为14%；HBV DNA载量超过8 Log10 I.U/ml时，风险为42%，P = 0.04，但与女性的来源、HBV基因型无关。
本研究证实，当母亲的HBV DNA载量超过5 Log10 I.U/ml时，无论女性的来源或HBV基因型如何，血清疫苗接种都不能完全保护新生儿免受母婴传播HBV的影响。
