Virological Determinants of Spontaneous Postpartum e Antigen Seroconversion and Surface Antigen Seroclearance in Pregnant Women Infected with Hepatitis B Virus

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• 作者：Yali Hu^a ; ^b ; ^&lowast ; ; Zhenhua Feng^c ; ^&lowast ; ; Jingli Liu^c ; Jie Chen^a ; Shu Zhang^a ; Yi-Hua Zhou^b ; ^c ; ^d ; ^{zgr03summer@126.com" class="auth_mail" title="E-mail the corresponding author}
• 关键词：HBeAg seroconversion ; HBsAg seroclearance ; Pregnant women ; Virological determinants
• 刊名：Archives of Medical Research
• 出版年：2016
• 出版时间：April 2016
• 年：2016
• 卷：47
• 期：3
• 页码：207-213
• 全文大小：318 K

文摘

We investigated the virological factors predicting spontaneous postpartum hepatitis B e antigen (HBeAg) seroconversion and hepatitis B surface antigen (HBsAg) seroclearance in pregnant women infected with hepatitis B virus (HBV).

Methods

We invited 419 HBV infected women whose sera had been collected during their pregnancy from August 2002–July 2004 and archived at −30°C, to participate the follow-up in October 2009–March 2010. Various virological factors were determined and compared in women with or without the seroconversion and seroclearance.

Results

A total of 264 (63.0%) antiviral naive women participated in the follow-up with an average observation period of 6.4 years (5.4–7.4). Of 76 women who were HBeAg positive during pregnancy, 42 (55.3%) seroconverted to anti-HBe during follow-up. Compared to pregnant women with HBV DNA ≥3 × 10⁷ IU/mL or HBeAg ≥770 S/CO, those with HBV DNA <3 × 10⁷ IU/mL or HBeAg <770 S/CO had higher conversion rate, with odds ratios (OR) of 7.32 (95% confidence interval [CI], 2.00–26.78) and 5.94 (95% CI, 1.40–25.16), respectively. Thirty eight (14.4%) women cleared HBsAg; pregnant women with HBsAg levels of 100–999 and <100 IU/mL had higher HBsAg seroclearance rate with OR of 2.58 (95% CI, 1.03–6.43) and 13.33 (95% CI, 5.07–35.07), respectively, compared to those with HBsAg >1000 IU/mL.

Conclusions

HBeAg-positive pregnant women with HBV DNA <3 × 10⁷ IU/mL or HBeAg <770 S/CO are more likely to undergo postpartum HBeAg seroconversion. HBsAg <100 IU/mL is a strong predictor of spontaneous postpartum HBsAg seroclearance.