Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 17 Section 3, Renmin South Road, Chengdu, Sichuan, 610041, People's Republic of China.
Department of Medical Laboratory Science, Women's Hospital, School of Medicine, Zhejiang University, Xueshi Road 1, Hangzhou, Zhejiang, 310006, People's Republic of China.
BMC Pediatr. 2021 Nov 4;21(1):492. doi: 10.1186/s12887-021-02967-8.
Serological testing for the presence of Hepatitis B Virus (HBV) markers and anti-HBs titers in infants born to HBsAg positive women is critically important for estimation in immunisation programme.
This was a multi-center and cross-sectional study conducted in Zhejiang province, China. Children aged 7 to 24 months born to HBsAg positive women during December 2018 to February 2019, completed additional HBV serological markers screening. We indicated distribution of HBV serological markers and anti-HBs titers in children. Multiple logistic regression model with adjusted odds ratio and 95% confidence interval (OR and 95% CI) was used to explore the factors associated with inadequate immune response (anti-HBs titers< 100 mIU/ml) among children.
A total of 1849 children were included. Overall 25 children tested HBsAg positive, giving HBsAg positive rate of 1.35%(95%CI: 0.83-1.88%). 92.00% (23/25) HBsAg positive children were delivered by HBeAg positive mothers. The proportion of protective seroconversion (anti-HBs titers≥10mIU/ml) was 99.29% in all children, and 86.48% children were reported with adequate anti-HBs titers (≥100mIU/ml).We found a significant higher proportions of early antenatal health care (< 13 gestational weeks), and term birth in children with adequate response compared with inadequate response (all P < 0.05). Logistic regression showed preterm birth was a negative factor for inadequate anti-HBs titers (OR = 1.868,95%CI 1.132-3.085,P = 0.015).
Children delivered by HBeAg positive mothers had higher risk of vertical transmission of HBV, despite completion of 3 doses of hepatitis B vaccine and HBIG injection. Inadequate anti-HBs level was significantly associated with preterm birth in HBsAg positive women.
对乙型肝炎病毒 (HBV) 标志物和抗-HBs 滴度呈阳性的 HBsAg 阳性妇女所生婴儿进行血清学检测，对于评估免疫接种计划至关重要。
这是一项在中国浙江省进行的多中心、横断面研究。2018 年 12 月至 2019 年 2 月期间，HBsAg 阳性妇女所生的 7 至 24 月龄儿童完成了额外的 HBV 血清学标志物筛查。我们说明了儿童中 HBV 血清学标志物和抗-HBs 滴度的分布情况。采用调整后的比值比和 95%置信区间（OR 和 95%CI）的多因素逻辑回归模型，探讨了与儿童中免疫反应不足（抗-HBs 滴度<100 mIU/ml）相关的因素。
共纳入 1849 名儿童。共有 25 名儿童 HBsAg 阳性，HBsAg 阳性率为 1.35%（95%CI：0.83-1.88%）。25 名 HBsAg 阳性儿童中，92.00%（23/25）为 HBeAg 阳性母亲所生。所有儿童的保护性血清转化率（抗-HBs 滴度≥10 mIU/ml）比例为 99.29%，86.48%的儿童报告抗-HBs 滴度充足（≥100 mIU/ml）。我们发现，与免疫反应不足的儿童相比，有足够反应的儿童中，早期产前保健（<13 孕周）和足月产的比例显著较高（均 P<0.05）。Logistic 回归显示，早产是导致抗-HBs 滴度不足的一个负面因素（OR=1.868，95%CI 1.132-3.085，P=0.015）。
尽管完成了 3 剂乙肝疫苗和 HBIG 注射，但 HBeAg 阳性母亲所生的儿童仍有较高的 HBV 垂直传播风险。抗-HBs 水平不足与 HBsAg 阳性妇女的早产显著相关。
