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Anti-HBc screening for the prevention of perinatal transmission of hepatitis B virus in France

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Summary

As anti-HBc screening has been proposed for blood donor testing, we investigated its effectiveness during pregnancy. Among 4,023 successive pregnant women screened for anti-HBc, 539 (13.4%) were positive and further tested for HBsAg and anti-HBs. HBsAg was found in 73 (1.81%) and anti-HBc only was positive in 66 (1.64%). Among the 73 women positive for HBsAg, HBV DNA was found in the serum of seven, the cord blood of two, the placenta of three. Of the 58 infants given HBV immunoglobulins and vaccine, only four had transient HBsAg. None of the 66 women positive for anti-HBc only had anti-HBc IgM, HBeAg, or HBV DNA in serum, cord blood or placenta but five women became HBsAg positive before, at, or after delivery. Among the infants born of these 66 mothers, three had high ALT, two had HBsAg and one HBV DNA without HBsAg. Screening for anti-HBc may be cost effective, at least in low HBV prevalence areas, since there is evidence for infectivity of pregnant women positive for anti-HBc only.

Zusammenfassung

Screening durch Anti-HBc-Antikörper-Bestimmung bei schwangeren Trägerinnen des Hepatitis B-Virus (HBV) zur Vorbeugung der perinatalen Übertragung von HBV. Screening auf anti-HBc wurde vorgeschlagen, um die HBV-Träger unter Blutspendern zu ermitteln. Wir haben die Wirkung eines solchen Screenings während der Schwangerschaft untersucht. Unter 4023 schwangeren Frauen, welche aufeinanderfolgend auf anti-HBc getestet wurden, zeigten sich 539 (13,4%) positiv und wurden auf HBsAg und anti-HBs getestet. HBsAg wurde bei 73 (1,81%) und anti-HBc allein bei 66 (1,64%) Frauen nachgewiesen. Unter den 73 HBsAg-positiven Frauen wiesen sieben HBV-DNA im Serum, zwei in der Nabelschnur und drei in der Plazenta auf. Unter den 58 Kindern, die HB-Immunglobulin und HBV-Impfstoff erhalten hatten, war nur bei vier vorübergehend HBsAg nachzuweisen. Von den 66 nur anti-HBc-positiven Frauen wies keine anti-HBc, IgM-Antikörper, HBeAg oder HBV-DNA im Serum, Nabelschnur, Blut oder Plazenta auf, aber fünf dieser Frauen wurden HBsAg-positiv vor, während oder nach der Niederkunft. Drei der von diesen 66 Müttern entbundenen Kinder hatten erhöhte ALT-Werte, zwei HBsAg und eines HBV-DNA ohne HBsAg. Das Screening auf anti-HBc kann zumindest in Gegenden mit geringer HBV-Prävalenz als effizient angesehen werden, da offensichtlich nur bei anti-HBc-positiven Frauen Infektiosität besteht.

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Authors and Affiliations

  1. Unité de Recherche sur les Hépatites et le Rôle des Virus Hépatotropes dans l'Oncogénèse, INSERM U 271, 69003, Lyon

    B. Descos M.D., C. Pichoud, M. Hermier M.D. & C. Trepo M.D.

  2. Unité de Recherche d'Hépatologie Pédiatrique, INSERM U 56, 94270, Bicêtre

    J. Scotto M.D. & J. Y. Huet

  3. Centre de Radioanalyse, Institut Pasteur, 69366, Lyon

    V. Fayol Ph. D. & G. Ville Ph. D.

  4. Services d'Obstétrique de L'Hôtel-Dieu, Lyon

    F. Charvet M.D. & J. M. Thoulon M.D.

  5. Services d'Obstétrique de l'Hôpital E. Herriot, Lyon, France

    D. Dargent M.D.

  6. Pavillon S, Hôpital Edouard Herriot, 69374, Lyon Cedex 08, France

    B. Descos

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  1. B. Descos M.D.
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  8. G. Ville Ph. D.
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Descos, B., Pichoud, C., Hermier, M. et al. Anti-HBc screening for the prevention of perinatal transmission of hepatitis B virus in France. Infection 15, 434–439 (1987). https://doi.org/10.1007/BF01647225

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  • DOI: https://doi.org/10.1007/BF01647225

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