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Immune Responses and Efficacy of Hepatitis B Vaccine in Neonates Born from Hepatitis B Carrier Mothers : Focus on HBV-DNA

Journal of the Korean Pediatric Society 1998;41(11):1498-1508.
Published online November 15, 1998.
Immune Responses and Efficacy of Hepatitis B Vaccine in Neonates Born from Hepatitis B Carrier Mothers : Focus on HBV-DNA
Jong-Hyun Kim, Jin-Han Kang, Chang-Kyu Oh
Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
B형 간염 바이러스 보유 산모로부터 분만된 신생아의 B형 간염 백신의 면역반응 및 효과 : HBV-DNA의 관점
김종현, 강진한, 오창규
가톨릭대학교 의과대학 소아과학교실
Correspondence: 
Jong-Hyun Kim, Email: 1
Abstract
Purpose
: The aim of this study was to elucidate the pathogenesis of vertical transmission of hepatitis B virus(HBV), and to study the protective efficacy of the vaccine and hepatitis B immune globulin(HBIG).
Methods
: Eighty-two infants born from HBV carrier mothers were studied. HBV plasma-derived vaccine and HBIG were administered to their neonates. Then, changes of viral markers, anti-preS2 and HBV-DNA were observed for 12 months.
Results
: The seroconversion rates of anti-HBs in infants of HBV carrier mothers at 4, 8 and 12 months were 85.4%(70/82), 75.6%(62/82) and 73.2%(60/82), respectively(P<0.05). The protective efficacy of the vaccine and HBIG at 12 months in infants from HBeAg positive and negative mothers were 89.5% and 100%, respectively. The detection rates of HBV-DNA by PCR in HBeAg positive and negative mothers were 83.3%(15/18) and 23.5%(8/34), respectively. By nested PCR, the detection rates improved to 94.4% (17/18) and 64.7%(22/34), respectively. In neonates from the HBeAg positive and negative mothers, HBV-DNA was only detected by nested PCR with 33.3%(6/18) and 2.9%(1/34), respectively. Five(6.1%) of 82 infants became infected by HBV from only HBeAg positive mothers during the follow-up period of 12 months. Three of 5 infected infants became HBV carriers. Detectable HBV-DNA(P=0.002) and HBsAg(P=0.02) in serum of infants at birth were significant factors to becoming a carrier.
Conclusion
: This study suggests that, in clarifying the HBsAg and HBV-DNA status in serum of the infants at birth, the highest risk group might be identified and treated with new and effective preventive methods.
Key Words: Hepatitis B virus, Vertical transmission, Protective efficacy, HBV-DNA, Polymerase chain reaction


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