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

Journal article
Authors Ann Söderström
Gunnar Norkrans
Magnus Lindh
Published in Scandinavian journal of infectious diseases
Volume 35
Issue 11-12
Pages 814-9
ISSN 0036-5548
Publication year 2003
Published at Institute of Internal Medicine, Dept of Infectious Diseases
Institute of Laboratory Medicine, Dept of Clinical Virology
Pages 814-9
Language en
Links www.ncbi.nlm.nih.gov/entrez/query.f...
Keywords 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
Subject categories Medical and Health Sciences

Abstract

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.

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