Risk factors and prophylactic strategies of hepatitis B virus vertical transmission

Chronic hepatitis B virus (HBV) infection is a principal risk factor for liver cirrhosis and hepatocellular carcinoma in China, representing one of the major public health problems. Horizontal transmission of HBV in vaccinated children was greatly reduced due to widespread HBV vaccination in mainland China, which had limited effects on vertical transmission. Thus, vertical transmission became one of the main causes of HBV chronic infection. High HBV load (≥ 10⁶ copies/mL) and hepatitis B e antigen (HBeAg)-positivity in maternal peripheral blood were independent risk factors for HBV intrauterine infection. Compared to HBV infection in early childhood and in adult, intrauterine HBV infection was more prone to developing chronic infection. To decrease vertical transmission of HBV, we recommend that young pregnant women with sero-positive for HBeAg and high serum HBV DNA level should receive antiviral treatment with nucleotide analogues since the 28th gestation weeks. For newborns born to HBeAg-positive mother, hepatitis B immunoglobulin (HBIG) injection should be administrated in combination with HBV vaccination.