Can HBeAg be used to predict high viral load in pregnant woman with hepatitis B viral infection in order to guide for antiviral prophylaxis?
Abstract
Objective : To study the correlation between positive HBeAg detection and high HBV viral load (≥200,000 IU/mL) in order to substitute for expensive HBV viral load.
Methods : 115 pregnant women infected with hepatitis B virus who followed up at antenatal care at Mahasarakham Hospital between November 1, 2016 to March 31, 2019 were included. This cross-sectional analytic study analyzed the relationship between positive HBeAg and high HBV viral load (≥200,000 IU/mL), using multivariable logistic regression to calculate odds ratio and 95% confidence interval.
Results : From total 115 hepatitis B virus infected mothers, 41 had positive HBeAg and 74 had negative HBeAg. 38/41 (92.7%) of HBeAg-positive mothers and 4/74 (5.4%) of HBeAg-negative mothers had high HBV viral load (≥200,000 IU/mL). Multivariable logistic regression analysis found a significant correlation between positive HbeAg and high HBV viral load (≥200,000 IU/mL) with odd ratio of 2464.22 (95% CI = 100.99 - 62109.76, p-value <0.001).
Conclusions : Positive HBeAg significantly correlates with high HBV viral load (≥200,000 IU/mL). Using HBeAg to replace HBV viral load in decision to prescribe antiviral drugs for prevention of perinatal hepatitis B virus transmission can save public health budgets.
Keywords : Hepatitis B virus, HBeAg, HBV viral load, prevention of perinatal hepatitis B virus transmission
References
Leroi C, Adam P, Khamduang W, et al. Prevalence of chronic hepatitis B virus infection in Thailand: a systematic review and meta-analysis. Int J Infect Dis. 2016;51:36-43.
Jourdain G, Ngo-Giang-Huong N, Cressey TR, et al. Prevention of mother-to-child transmission of hepatitis B virus: a phase III, placebo-controlled, double-blind, randomized clinical trial to assess the efficacy and safety of a short course of tenofovir disoproxil fumarate in women with hepatitis B virus e-antigen. BMC Infect Dis. 2016;16:393.
WHO. Prevention, care and treatment of persons with chronic hepatitis B infection. Guidelines. WHO;2015. Available from: http://apps.who.int/iris/ bitstream/10665/154590/1/9789241549059_eng.pdf
Han GR, Cao MK, Zhao W, et al. A prospective and open-label study for the efficacy and safety of telbivudine in pregnancy for the prevention of perinatal transmission of hepatitis B virus infection. J Hepatol. 2011;55(6):1215-21.
Terrault NA, Lok ASF, MaMahon BJ, et al. Update on prevention, diagnosis, and treatment of chronic hepatitis B: AASLD 2018 hepatitis B guidance. Hepatology. 2018;67(4):1560-1599.
Wen WH, Chang MH, Zhao LL, et al. Mother-to-infant transmission of hepatitis B virus infection: significance of maternal viral load and strategies for intervention. J Hepatol. 2013;59(1):24-30.
Trépo C, Chan HL, Lok A. Hepatitis B virus infection. Lancet. 2014;384(9959):2053-63.
Jennifer TW and Robert P. Hepatitis B. Sleisenger and Fordtran’s Gastrointestinal and Liver Diseae, 10th edition. 2016;1309-31
Zou H, Chen Y, Duan Z, et al. Virologic factors associated with failure to passive-active immunoprophylaxis in infants born to HBsAg-positive mothers. J Viral Hepat. 2012;19(2):e18-25.
Fujiko M, Chalid MT, Turyadi, et al. Chronic hepatitis B in pregnant women: is hepatitis B surface antigen quantification useful for viral load prediction? Int J Infect Dis. 2015;41:83-9.
Peduzzi P, Concato J, Kemper E, et al. A simulation study of the number of events per variable in logistic regression analysis. J Clin Epidemiol. 1996;49 (12):1373-9
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