Is hepatitis B virus transmitted via the male germ line? A seroepidemiological study in fetuses

SummaryObjectivesTo detect father-to-fetus transmission of hepatitis B virus (HBV) in utero.MethodsWe conducted a study at the prenatal diagnosis center of Taizhou City. Fetuses with one or both parents carrying the hepatitis B surface antigen (HBsAg) were identified before genetic testing during the period 2008–2010. Intrauterine samples were obtained by amniocentesis or cordocentesis and tested for serological markers and by quantitative DNA assays. All neonates received combined hepatitis B immunoprophylaxis after delivery, and serological follow-up tests were performed at 1 year of age.ResultsOf the 407 couples enrolled in the study, HBV was carried by fathers only in 164, and none of their fetuses were found to be HBV DNA-positive in utero. All fetal serological markers were found to be of maternal but not paternal origin. The response rate to postnatal vaccination was 98.6%, and none of the children who failed immunoprophylaxis were the offspring of the HBV carrier fathers.ConclusionsThe infection of fetuses with HBV from the spermatozoa of carrier fathers seems unlikely, especially in an area where pre-conception hepatitis B vaccination is routinely provided.