Serum ALT levels as a surrogate marker for serum HBV DNA levels in HBeAg-negative pregnant women

• In Stockholm, Sweden, the majority of pregnant women positive for hepatitis B surface antigen (HBsAg) are hepatitis Be antigen (HBeAg) negative. Newborns to HBeAg positive mothers receive vaccination and hepatitis B immunoglobulin (HBIg). Newborns to HBeAg negative mothers receive vaccine and HBIg only if the mothers have elevated ALT levels. The aim of this study was to retrospectively evaluate ALT levels as a surrogate marker for HBV DNA levels in HBeAg negative carrier mothers. Altogether 8947 pregnant women were screened for HBV markers from 1999 to 2001 at the Virology Department, Karolinska Hospital. Among mothers screened 192 tested positive for HBsAg (2.2%). 13 of these samples could not be retrieved. Of the remaining 179 sera, 8 (4%) tested positive for HBeAg and 171 (95.5%) were HBeAg negative. Among the HBeAg negative mothers, 9 had HBV DNA levels > 10(5) copies/ml, and of these 7 had normal ALT levels indicating low sensitivity of an elevated ALT level as a surrogate marker for high HBV DNA level. Furthermore, no correlation was found between ALT and HBV DNA levels. Hence, it is concluded that the use of ALT as a surrogate marker for high viral replication in HBeAg negative mothers could be questioned.

Nyckelord

Adult

Alanine Transaminase/*blood

Base Sequence

Biological Markers/blood

Carrier State/*transmission

Case-Control Studies

Confidence Intervals

DNA; Viral/analysis

Disease Transmission; Vertical/*prevention & control

Female

Hepatitis B/prevention & control/*transmission

Hepatitis B e Antigens/*analysis

Hepatitis B virus/*immunology/isolation & purification

Humans

Infant; Newborn

Mass Screening

Molecular Sequence Data

Polymerase Chain Reaction/methods

Pregnancy

Pregnancy Complications; Infectious/diagnosis

Pregnancy Outcome

Prenatal Care

Probability

Reference Values

Retrospective Studies

Sensitivity and Specificity

Serologic Tests

Statistics; Nonparametric

Sweden

MEDICINE

MEDICIN

Publikations- och innehållstyp

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