Chang M H, Hsu H Y, Huang L M, Lee P I, Lin H H, Lee C Y
Department of Pediatrics and Obstetrics, College of Medicine, National Taiwan University, Taipei, Taiwan.
J Hepatol. 1996 Jun;24(6):674-9. doi: 10.1016/s0168-8278(96)80262-5.
AIMS/METHODS: To investigate the influence of transplacental hepatitis B core antibody (anti-HBc) on perinatal hepatitis B virus (HBV) transmission, we studied the anti-HBc titers in 294 mother-neonate pairs.
The anti-HBc titer was highest (10(5.13 +/- 0.80) to 10(4.36 +/- 0.97) in mothers, 10(5.13 +/- 0.76) to 10(5.52 +/- 0.98) in infants) in the 200 hepatitis B e antigen (HBeAg) positive hepatitis B surface antigen (HBsAg) carrier mothers and their infants, second highest (10(4.51 +/- 0.76) and 10(4.68 +/- 0.76)) in the 60 HBeAg-negative HBsAg carrier mothers and their infants, and lowest (10(3.11 +/- 0.76) and 10(3.24 +/- 0.83)) in the 34 non-carrier mothers and their infants (p < 0.05). One hundred and ninety-two infants of HBeAg-positive carrier mothers received hepatitis B immunoglobulin as well as hepatitis B vaccines, and were followed prospectively from birth. Ten infants became HBsAg carriers, and their mothers had significantly lower anti-HBc titers than those of the mothers of 182 infants who did not become carriers (p = 0.003), while maternal serum hepatitis B virus DNA levels (29.9 +/- 23.6 versus 39.9 +/- 58.1 pg/10 ml) did not differ in those two groups (p > 0.25). The same trend was observed in the infants' anti-HBc titers in those two groups (p = 0.0006).
The association of lower anti-HBc titers in HBeAg-positive carrier mother-infant pairs and the development of carrier status in the infants suggests a positive role of anti-HBc in the modulation of mother-to-infant transmission of HBV. A high maternal anti-HBc level in serum may be a negative predictor of immunoprophylaxis failure in high-risk infants.
目的/方法：为研究经胎盘乙肝核心抗体（抗-HBc）对围产期乙肝病毒（HBV）传播的影响，我们对294对母婴进行了抗-HBc滴度研究。
在200对乙肝e抗原（HBeAg）阳性乙肝表面抗原（HBsAg）携带者母婴中，抗-HBc滴度最高（母亲为10(5.13±0.80)至10(4.36±0.97)，婴儿为10(5.13±0.76)至10(5.52±0.98)）；在60对HBeAg阴性HBsAg携带者母婴中，抗-HBc滴度次之（分别为10(4.51±0.76)和10(4.68±0.76)）；在34对非携带者母婴中，抗-HBc滴度最低（分别为10(3.11±0.76)和10(3.24±0.83)）（p<0.05）。192名HBeAg阳性携带者母亲的婴儿接受了乙肝免疫球蛋白和乙肝疫苗，并从出生起进行前瞻性随访。10名婴儿成为HBsAg携带者，其母亲的抗-HBc滴度显著低于182名未成为携带者的婴儿的母亲（p = 0.003），而两组母亲血清乙肝病毒DNA水平（29.9±23.6对39.9±58.1 pg/10 ml）无差异（p>0.25）。两组婴儿的抗-HBc滴度也呈现相同趋势（p = 0.0006）。
HBeAg阳性携带者母婴中抗-HBc滴度较低与婴儿携带者状态的发展之间的关联表明，抗-HBc在调节HBV母婴传播中起积极作用。母亲血清中高抗-HBc水平可能是高危婴儿免疫预防失败的阴性预测指标。
