All issues > Volume 50(4); 2007

Original Article

Korean J Pediatr. 2007;50(4):347-354. Published online April 15, 2007.

The outcome of perinatal prophylaxis for HBeAg positive mothers according to the maternal HBV-DNA levels at the delivery time

On O Jeong¹, Jong-Hyun JH Kim¹

¹Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea

Correspondence Jong-Hyun JH Kim ,Email: jh00mn@catholic.ac.kr

Abstract

Purpose
: Perinatal hepatitis B viral infection is decreasing; however, 10% of babies to HBeAg positive mothers still become chronic carriers despite perinatal prophylaxis. Although, the cause of prophylaxis failure is still unclear, an importance of maternal HBV-DNA level at the delivery time has been suggested. This study was established to certify if it would be a useful predictable factor for the outcome of perinatal prophylaxis.
Methods
: Twenty-nine HBeAg positive mothers whose babies had known outcomes of prophylaxis were selected. To determine the amount of maternal HBV-DNA, a quantitative PCR was performed with the WHO International Standard for HBV DNA NAT assays.
Results
: The mean logarithm HBV-DNA level of mothers with failed outcomes was significantly higher than that of mothers with succeessful outcomes (7.99 vs. 6.72, P=0.015). The predictable maternal HBV-DNA cut-off level to prophylaxis outcome was 2.83?07 copies/mL (100 pg/mL). None out of the case 16 (0%) who had below this level, and 5 out of 13 (38.5%) who had above this level of maternal HBV-DNA failed in perinatal prophylaxis.
Conclusion
: Mothers with higher levels of HBV-DNA at delivery time would be prone to a worse outcome of prophylaxis using the conventional approach. Perinatal prophylaxis failure rate can be reduced, if we try to introduce more potent prophylactic treatment into the cases with this risk factor.

Keywords :Hepatitis B , Perinatal infection , Real time PCR , Maternal HBV-DNA , Prophylaxis failure