The relationship of maternal hepatitis B e antigen and response to vaccination of infants born to women with chronic infection

BMC Pregnancy Childbirth. 2023 Jul 15;23(1):518. doi: 10.1186/s12884-023-05815-y.

Abstract

Background: The relationship of maternal HBeAg and infants' response to hepatitis B vaccine remains controversial. This study aims to observe the dynamic changes in infant birth HBV markers and study the time-varying effects of maternal HBeAg on vaccination response of infants born to women with chronic HBV infection.

Methods: 3163 infants born to HBsAg positive mothers including 1737 with maternal HBeAg positive in group A and 1426 negative in group B were enrolled eventually. Demographic information and laboratory tests were collected at birth, 7-12th and 24th month. The dynamic changes of infant HBV markers and HBsAb titers at different time points were compared between the two groups.

Results: The infant HBV markers at birth displayed different modes. During the follow-up, we observed a significant downward trend in the positive rates of HBsAg, HBeAg, HBeAb and HBcAb. The HBsAg of two groups switched to negative at 7-12 months and HBeAg in Group A became negative at 24 months. The HBsAb titers of the infants in the two groups were 576.91(192.8-1000.0) vs 719.67(208.1-1000.0) at 7-12 months (Z = -3.049, P = 0.002) and 783.5(227.8-1000.0) vs 891.4(234.0-1000.0) at 24 months (Z = -0.853, P = 0.394). High HBV DNA viral load (OR 1.260, 95% CI 1.139-1.395, P < 0.001) and maternal HBeAg level (OR 1.003, 95% CI 1.002-1.003, P < 0.001) were associated with the higher HBeAg positive rate of infants.

Conclusions: Maternal HBeAg did affect the infants' immune response to vaccination and reduce the anti-response at 7-12th month temporarily, but these influences were negligible by 24th months after birth, which proved that the maternal HBeAg would not induce immune tolerance of infants from a long-term perspective.

Keywords: Follow-up; HBV marker; Hepatitis B virus; Hepatitis B virus DNA; Immunization; Maternal hepatitis B e antigen.

MeSH terms

  • DNA, Viral
  • Female
  • Hepatitis B Antibodies
  • Hepatitis B Surface Antigens
  • Hepatitis B Vaccines
  • Hepatitis B e Antigens
  • Hepatitis B virus
  • Hepatitis B* / prevention & control
  • Humans
  • Infant
  • Infant, Newborn
  • Infectious Disease Transmission, Vertical / prevention & control
  • Persistent Infection
  • Pregnancy
  • Pregnancy Complications, Infectious*
  • Vaccination

Substances

  • Hepatitis B e Antigens
  • Hepatitis B Surface Antigens
  • DNA, Viral
  • Hepatitis B Vaccines
  • Hepatitis B Antibodies