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      Epidemiological characteristics of immunoprophylaxis failure in the infants born to HBsAg-positive mothers in Quanzhou, Fujian

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          Abstract

          Objective To explorethe status of hepatitis B immunization in children born to HBsAg-positive mothers in Quanzhou City, and evaluate the effects on blocking HBV maternal-neonatal transmission, and analyze the epidemiological characteristics of neonatal immunoprophylaxis failure.

          Methods A questionnaire survey was conducted to collect the information of HBsAg -positive mothers and their neonates in Hui'an and Shishi counties of Quanzhou City. Venous blood samples were collected from the infants after 1-2 months when they completed 3 doses of hepatitis B vaccine, and serum HBsAg, anti-HBs were detected by colloidal gold method.

          Results The anti-HBs positive rate and HBsAg-positive rate of infants were respectively 93.1% and 1.8%. The infants' immunoprophylaxis failure rate was 6.9 %, which was associated with ALT, HBV-DNA values and HBeAg status of mothers (P<0.05). The higher the ALT and HBV-DNA values was, the greater probability of immunoprophylaxis failure was. The neonatal immune failure rate of HBeAg-positive mothers was significantly higher than that of HBeAg-negative. Blocking mother-to-infant transmission of HBV was associated with ALT and HBV-DNA values in HBsAg-positive women ( P<0.05). The higher the ALT and HBV-DNA values was, the greater probability of maternal-infant block failure. The 20 —g/mL hepatitis B vaccine and 200 IU HBIG vaccination rate in children whose mother's HBV-DNA≥10 4 cps / mL was significantly higher than whom of HBV-DNA<10 4 cps / mL.

          Conclusion The current immunological strategy in Quanzhou has well protective efficacy for the interruption of HBV mother-to-infant transmission. It is recommended that mothers with HBeAg-positive and HBV DNA >6 log10 IU/mL should be intervented during pregnancy to further reduce the rate of immunoprophylaxis failure and increase the blockage of HBV maternal-neonatal transmission.

          Abstract

          摘要: 目的 的了解泉州市HBsAg阳性产妇所生儿童的乙肝免疫状况, 评价本市乙肝母婴阻断方案的保护效果, 并 分析免疫失败的流行特征。 方法 通过问卷调查, 收集整理泉州市惠安、石狮两县HBsAg阳性产妇及其新生儿基本信 息, 在新生儿完成3针乙肝疫苗接种后1~2月, 采集血标本并通过胶体金法检测HBsAg、抗HBs。 结果 HBsAg阳性产 妇所生儿童经乙肝疫苗和乙肝免疫球蛋白(HBIG)联合免疫后, 其抗-HBs阳性率为93.1%, HBsAg阳性率为1.8%, 免疫 失败率为6.9%。新生儿乙肝免疫失败与HBsAg阳性产妇谷丙转氨酶(ALT)值和HBV-DNA值高低、产妇HBeAg阳性 与否有关(P<0.05), ALT、HBV-DNA值越高, 免疫失败的概率越大, HBeAg阳性产妇所生新生儿免疫失败率高于HBeAg 阴性;乙肝母婴阻断与HBsAg阳性产妇ALT值和HBV-DNA值高低有关(P<0.05), ALT、HBV-DNA值越高, 母婴阻断失 败的概率越大。HBV-DNA≥10 4cps/mL HBsAg阳性产妇选择20 —g/mL乙肝疫苗和200 IU HBIG进行接种的率明显高于 HBV-DNA<10 4cps/mL产妇。结论泉州市现行乙肝母婴阻断策略实施效果较好, 建议HBeAg阳性且HBV DNA载量> 6 log10 IU/mL的母亲在孕期进行干预治疗, 以进一步减少免疫失败率, 提高母婴阻断率。

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          Author and article information

          Journal
          CTM
          China Tropical Medicine
          China Tropical Medicine (China )
          1009-9727
          1 March 2020
          1 April 2020
          : 20
          : 3
          : 245-248
          Affiliations
          1Quanzhou City Center for Disease Control and Prevention, Quanzhou, Fujian 362000, China
          2School of Public Health, Fujian Medical University, Fuzhou, Fujian 350001, China
          Article
          j.cnki.46-1064/r.2020.03.11
          10.13604/j.cnki.46-1064/r.2020.03.11
          © 2020 Editorial Department of China Tropical Medicine

          This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 Unported License (CC BY-NC 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See https://creativecommons.org/licenses/by-nc/4.0/.

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