Highlights
- •HBsAg carrier rates have fallen below 2% in the Taiwanese population born within the last 35 years.
- •Approximately 5% of vaccinated individuals had occult HBV infection (OBI).
- •<1% of vaccinated pregnant mothers were HBsAg carriers, whereas around 6% had OBI in the present study.
- •It was possible for mothers with OBI to transmit HBV to their babies.
- •Viremia was cleared 1 year after completing the hepatitis B vaccination series.
Background & Aims
In the Taiwanese population born in the universal vaccination era, HBsAg carrier rates
have fallen below 2%, while approximately 5% develop occult hepatitis B infection
(OBI). However, the potential for transmission from mothers with OBI to their infants
has not been well studied. We aimed to investigate whether mothers with OBI could
transmit HBV to their babies.
Methods
A total of 253 pregnant women who were born after July 1986 and had been fully vaccinated
against HBV during infancy were recruited from a tertiary hospital in Northern Taiwan.
HBV serology and DNA levels were determined. Babies born to mothers with OBI were
followed-up until 1 year of age. The surface genes were sequenced.
Results
HBV infection was documented in 18 vaccinated mothers, 2 of whom were HBsAg-reactive
(0.79 %). Seventeen were positive for HBV DNA, among whom 16 (6.32%) presented with
OBI with a median DNA level of 145 IU/ml (interquartile range: 37.8–657.3 IU/ml).
Eleven babies born to 10 mothers with OBI were recruited. Three babies were HBsAg-reactive,
and 2 were positive for HBV DNA (17.0 and 212.0 IU/ml). Seven mothers with OBI carried
multiple surface gene variants. Two transiently infected babies harbored variants
originating from their mother’s HBV quasi-species. All infants received complete hepatitis
B vaccines. At 12 months of age, none of the babies were positive for HBsAg or HBV
DNA.
Conclusions
It was possible for mothers with OBI to transmit HBV to their babies, who consequently
harbored surface gene variants originating from their mothers’ minor variants. Viremia
was cleared 1 year after completing the hepatitis B vaccination series.
Lay summary
Since initiating the hepatitis B vaccination program in Taiwan, the rate of young
individuals (i.e. born after 1986) carrying the HBV surface antigen has fallen below 2%, although around
5% of vaccinated individuals develop occult HBV infections. Herein, we show that pregnant
mothers with occult HBV infections can transmit HBV to their offspring. However, no
infant had sustained infection at 1 year of age having completed a full HBV vaccination
series.
Graphical abstract
Graphical Abstract
Keywords
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Article info
Publication history
Published online: February 13, 2022
Accepted:
January 28,
2022
Received in revised form:
January 6,
2022
Received:
July 8,
2021
Footnotes
Author names in bold designate shared co-first authorship
Identification
Copyright
© 2022 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
