Hepatitis B virus DNA during pregnancy and post partum: aspects on vertical transmission.

• Little is known about how pregnancy influences viremia levels in women with chronic hepatitis B virus infection. In this study, we first retrospectively analysed changes in HBV DNA levels during and after 55 pregnancies in HBsAg-positive women, of whom 9 were HBeAg-positive. Secondly, HBV DNA levels in 3 HBeAg-positive mothers whose babies became chronic HBV carriers, were compared with levels in 18 mothers whose babies were not infected by HBV. We found that HBV DNA ranged from 10(8.1) to 10(9.5) copies/mL in HBeAg-positive, and from undetectable (< 100) to 10(6.8) copies/mL in HBeAg-negative mothers. HBV DNA increased by a mean of 0.4 log late in pregnancy or early post partum; in 4 out of 16 HBeAg negative mothers by > 1 log during pregnancy. Post partum ALT increased in both HBeAg-positive and negative women. HBV DNA was 10(9.4)-10(10.4) copies/mL in 3 HBeAg-positive mothers whose babies were, as compared to < 100-10(10.4) copies/mL in 18 whose babies were not, vertically infected. Although the majority of HBeAg-negative women had low and relatively stable HBV DNA during pregnancy, viremia was also relatively high in some HBeAg-negative mothers, and both viremia and ALT increased significantly late in pregnancy or shortly after delivery. Vertical transmission was only seen in HBeAg-positive mothers with very high levels of viremia. The value of measuring HBV DNA in the pregnant woman to modify immunoprophylaxis to her infant needs further study.

Nyckelord

Cohort Studies

DNA

Viral

analysis

Disease Transmission

Vertical

statistics & numerical data

Female

Follow-Up Studies

Hepatitis B

diagnosis

epidemiology

transmission

Hepatitis B e Antigens

analysis

Hepatitis B virus

isolation & purification

Humans

Incidence

Infant

Newborn

Male

Polymerase Chain Reaction

methods

Postpartum Period

Pregnancy

Pregnancy Complications

Infectious

diagnosis

virology

Pregnancy Outcome

Probability

Retrospective Studies

Risk Assessment

Statistics

Nonparametric

Sweden

epidemiology

Publikations- och innehållstyp

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art (ämneskategori)