HBV viremia in newborns of HBsAg(+) predominantly Caucasian HBeAg(−) mothers

BackgroundHepatitis B virus infection is an important public health problem worldwide and eliminating mother-to-infant transmission is important to decrease the prevalence of chronic HBV-infection. Although, immunoprophylaxis given at birth largely prevents mother-to-infant transmission, perinatal HBV viremia has been reported in HBsAg(−) newborns born mainly to HBeAg(+) women in endemic areas.ObjectivesTo examine the incidence of perinatal HBV viremia in newborns of HBsAg(+) predominantly HBeAg(−) mothers.Study designPeripheral blood was obtained at birth from 109 HBsAg(+) mothers and their newborns before the administration of active–passive immunoprophylaxis. Infants were prospectively followed and appropriately vaccinated.ResultsAlthough most (92.7%) of the HBsAg(+) mothers were HBeAg(−), 73.4% had detectable HBV viremia. Neonatal viremia was detected in 3/8 (37.5%) and 24/101 (23.8%) newborns of HBeAg(+) and HBeAg(−) mothers, respectively (p = 0.386). However, HBV–DNA levels were significantly higher in newborns of HBeAg(+) mothers (p = 0.025). No child developed chronic HBV infection, but one child had evidence of subclinical hepatitis.ConclusionsAlthough the clinical significance of low viremia levels in almost one in four newborns of HBsAg(+) mothers in a low endemicity area is unclear, it may enhance our understanding of HBV mother-to-infant transmission.