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Published in: BMC Pregnancy and Childbirth 1/2018

Open Access 01-12-2018 | Research article

Comparison of hepatitis B viral loads and viral antigen levels in child-bearing age women with and without pregnancy

Authors: Chenyu Xu, Jingli Liu, Lanhua Liu, Yongchun Bi, Biyun Xu, Jie Chen, Biao Xu, Tingmei Chen, Yali Hu, Yi-Hua Zhou

Published in: BMC Pregnancy and Childbirth | Issue 1/2018

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Abstract

Background

Pregnancy is a unique physiological condition with the cellular immune functions compromised at some extents to allow the mature of growing fetus. Whether pregnancy may influence the replication of hepatitis B virus (HBV) is less studied. The present study aimed to investigate the influence of pregnancy on the replication of HBV and expression of viral antigens by comparing the levels of HBV DNA and viral antigens in pregnant and non-pregnant women.

Methods

A total of 727 HBsAg-positive serum samples, collected from 214 pregnant women and 513 non-pregnant women of childbearing age, were included. Based on the pregnancy status, subjects were divided into four groups: nulliparous (n = 158), pregnant (n = 214), 7–12 months postpartum (n = 170), and 2–5 years postpartum (n = 185). The levels of hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) were quantitatively measured with microparticle enzyme immunoassay. HBV DNA levels were detected by fluorescent real-time PCR.

Results

The median ages of four groups were 25.0, 25.3, 26.2 and 29.3 years, respectively (p < 0.01). HBeAg-positive proportions were 34.2, 33.6, 35.3 and 29.2%, respectively (p = 0.624). HBV DNA levels in HBeAg-positive women were higher than those in HBeAg-negative women (7.88 vs 2.62 log IU/ml, p < 0.001). HBV DNA levels in the four groups with positive HBeAg were 7.8, 7.7, 8.0 and 8.0 log IU/ml, respectively (p = 0.057), while HBsAg titers were 4.4, 4.5, 4.6 and 4.8 log IU/ml (p = 0.086) and HBeAg titers were 3.1, 3.0, 3.1 and 3.0 log S/CO (p = 0.198). In the four groups with negative HBeAg, HBV DNA levels were 2.3, 2.6, 2.5 and 2.8 log IU/ml, respectively (p = 0.085), while HBsAg titers were 3.1, 3.3, 3.3 and 3.0 log IU/ml (p = 0.06).

Conclusions

Serum levels of HBV DNA and viral antigens showed no significant changes in nulliparous, pregnant, and postpartum women, regardless of the HBeAg status. The results indicate that pregnancy has little influence on the replication of HBV and the expression of viral antigens.
Literature
1.
go back to reference Schweitzer A, Horn J, Mikolajczyk RT, Krause G, Ott JJ. Estimations of worldwide prevalence of chronic hepatitis B virus infection: a systematic review of data published between 1965 and 2013. Lancet. 2015;386(10003):1546–55.CrossRefPubMed Schweitzer A, Horn J, Mikolajczyk RT, Krause G, Ott JJ. Estimations of worldwide prevalence of chronic hepatitis B virus infection: a systematic review of data published between 1965 and 2013. Lancet. 2015;386(10003):1546–55.CrossRefPubMed
2.
go back to reference Lin X, Yang J, Lu H, Zhou Y, Zhou G, Wu H, et al. Minimization of hepatitis B infection among children in Jiangsu, China, 12 years after integration of hepatitis B vaccine into the expanded program on immunization. Vaccine. 2016;34(51):6458–63.CrossRefPubMed Lin X, Yang J, Lu H, Zhou Y, Zhou G, Wu H, et al. Minimization of hepatitis B infection among children in Jiangsu, China, 12 years after integration of hepatitis B vaccine into the expanded program on immunization. Vaccine. 2016;34(51):6458–63.CrossRefPubMed
3.
go back to reference Zhao H, Zhou YH. Revaccination against hepatitis B in late teenagers who received vaccination during infancy: yes or no? Hum Vaccin Immunother. 2018;14(2):456–63.CrossRefPubMed Zhao H, Zhou YH. Revaccination against hepatitis B in late teenagers who received vaccination during infancy: yes or no? Hum Vaccin Immunother. 2018;14(2):456–63.CrossRefPubMed
4.
go back to reference Hahné S, van den Hoek A, Baayen D, van der Sande M, de Melker H, Boot H. Prevention of perinatal hepatitis B virus transmission in the Netherlands, 2003-2007: children of Chinese mothers are at increased risk of breakthrough infection. Vaccine. 2012;30(9):1715–20.CrossRefPubMed Hahné S, van den Hoek A, Baayen D, van der Sande M, de Melker H, Boot H. Prevention of perinatal hepatitis B virus transmission in the Netherlands, 2003-2007: children of Chinese mothers are at increased risk of breakthrough infection. Vaccine. 2012;30(9):1715–20.CrossRefPubMed
5.
go back to reference Schillie S, Walker T, Veselsky S, Crowley S, Dusek C, Lazaroff J, et al. Outcomes of infants born to women infected with hepatitis B. Pediatrics. 2015;135(5):e1141–7.CrossRefPubMed Schillie S, Walker T, Veselsky S, Crowley S, Dusek C, Lazaroff J, et al. Outcomes of infants born to women infected with hepatitis B. Pediatrics. 2015;135(5):e1141–7.CrossRefPubMed
6.
go back to reference Wei KP, Zhu FC, Liu JX, Yan L, Lu Y, Zhai XJ, et al. The efficacy of two different dosages of hepatitis B immunoglobulin combined with hepatitis B vaccine in preventing mother-to-child transmission of hepatitis B virus: a prospective cohort study. Vaccine. 2018;36(2):256–63.CrossRefPubMed Wei KP, Zhu FC, Liu JX, Yan L, Lu Y, Zhai XJ, et al. The efficacy of two different dosages of hepatitis B immunoglobulin combined with hepatitis B vaccine in preventing mother-to-child transmission of hepatitis B virus: a prospective cohort study. Vaccine. 2018;36(2):256–63.CrossRefPubMed
7.
go back to reference Jourdain G, Ngo-Giang-Huong N, Harrison L, Decker L, Khamduang W, Tierney C, et al. Tenofovir versus placebo to prevent perinatal transmission of hepatitis B. N Engl J Med. 2018;378(10):911–23.CrossRefPubMed Jourdain G, Ngo-Giang-Huong N, Harrison L, Decker L, Khamduang W, Tierney C, et al. Tenofovir versus placebo to prevent perinatal transmission of hepatitis B. N Engl J Med. 2018;378(10):911–23.CrossRefPubMed
8.
go back to reference Brown RS Jr, McMahon BJ, Lok AS, Wong JB, Ahmed AT, Mouchli MA, et al. Antiviral therapy in chronic hepatitis B viral infection during pregnancy: a systematic review and meta-analysis. Hepatology. 2016;63(1):319–33.CrossRefPubMed Brown RS Jr, McMahon BJ, Lok AS, Wong JB, Ahmed AT, Mouchli MA, et al. Antiviral therapy in chronic hepatitis B viral infection during pregnancy: a systematic review and meta-analysis. Hepatology. 2016;63(1):319–33.CrossRefPubMed
9.
go back to reference Lu Y, Zhu FC, Liu JX, Zhai XJ, Chang ZJ, Yan L, et al. The maternal viral threshold for antiviral prophylaxis of perinatal hepatitis B virus transmission in settings with limited resources: a large prospective cohort study in China. Vaccine. 2017;35(48 Pt B):6627–33.CrossRefPubMed Lu Y, Zhu FC, Liu JX, Zhai XJ, Chang ZJ, Yan L, et al. The maternal viral threshold for antiviral prophylaxis of perinatal hepatitis B virus transmission in settings with limited resources: a large prospective cohort study in China. Vaccine. 2017;35(48 Pt B):6627–33.CrossRefPubMed
10.
go back to reference Zhou YH. Prevention of mother-to-child transmission of hepatitis B virus by treating mothers with high viral loads. Hepatology. 2016;64(5):1823–4.CrossRefPubMed Zhou YH. Prevention of mother-to-child transmission of hepatitis B virus by treating mothers with high viral loads. Hepatology. 2016;64(5):1823–4.CrossRefPubMed
11.
go back to reference Chen ZX, Gu GF, Bian ZL, Cai WH, Shen Y, Hao YL, et al. Clinical course and perinatal transmission of chronic hepatitis B during pregnancy: a real-world prospective cohort study. J Infect. 2017;75(2):146–54.CrossRefPubMed Chen ZX, Gu GF, Bian ZL, Cai WH, Shen Y, Hao YL, et al. Clinical course and perinatal transmission of chronic hepatitis B during pregnancy: a real-world prospective cohort study. J Infect. 2017;75(2):146–54.CrossRefPubMed
12.
go back to reference Hu Y, Xu C, Xu B, Hu L, Liu Q, Chen J, et al. Safety and efficacy of telbivudine in late pregnancy to prevent mother-to-child transmission of hepatitis B virus: a multicenter prospective cohort study. J Viral Hepat. 2018;25(4):429–37.CrossRefPubMed Hu Y, Xu C, Xu B, Hu L, Liu Q, Chen J, et al. Safety and efficacy of telbivudine in late pregnancy to prevent mother-to-child transmission of hepatitis B virus: a multicenter prospective cohort study. J Viral Hepat. 2018;25(4):429–37.CrossRefPubMed
13.
go back to reference Rajbhandari R, Barton K, Juncadella AC, Rubin AK, Ajayi T, Wu Y, et al. Discontinuity of care for mothers with chronic hepatitis B diagnosed during pregnancy. J Viral Hepat. 2016;23(7):561–8.CrossRefPubMed Rajbhandari R, Barton K, Juncadella AC, Rubin AK, Ajayi T, Wu Y, et al. Discontinuity of care for mothers with chronic hepatitis B diagnosed during pregnancy. J Viral Hepat. 2016;23(7):561–8.CrossRefPubMed
14.
go back to reference Trowsdale J, Betz AG. Mother’s little helpers: mechanisms of maternal-fetal tolerance. Nat Immunol. 2006;7(3):241–6.CrossRefPubMed Trowsdale J, Betz AG. Mother’s little helpers: mechanisms of maternal-fetal tolerance. Nat Immunol. 2006;7(3):241–6.CrossRefPubMed
15.
go back to reference Fujikawa T, Numazaki K, Asanuma H, Kudo R, Tsutsumi H. Frequency of human cytomegalovirus-specific T cells during pregnancy determined by intracellular cytokine staining. J Med Virol. 2003;71(4):527–31.CrossRefPubMed Fujikawa T, Numazaki K, Asanuma H, Kudo R, Tsutsumi H. Frequency of human cytomegalovirus-specific T cells during pregnancy determined by intracellular cytokine staining. J Med Virol. 2003;71(4):527–31.CrossRefPubMed
16.
go back to reference Alanen A, Kahala K, Vahlberg T, Koskela P, Vainionpää R. Seroprevalence, incidence of prenatal infections and reliability of maternal history of varicella zoster virus, cytomegalovirus, herpes simplex virus and parvovirus B19 infection in south-western Finland. BJOG. 2005;112(1):50–6.CrossRefPubMed Alanen A, Kahala K, Vahlberg T, Koskela P, Vainionpää R. Seroprevalence, incidence of prenatal infections and reliability of maternal history of varicella zoster virus, cytomegalovirus, herpes simplex virus and parvovirus B19 infection in south-western Finland. BJOG. 2005;112(1):50–6.CrossRefPubMed
17.
go back to reference Gervais A, Bacq Y, Bernuau J, Martinot M, Auperin A, Boyer N, et al. Decrease in serum ALT and increase in serum HCV RNA during pregnancy in women with chronic hepatitis C. J Hepatol. 2000;32(2):293–9.CrossRefPubMed Gervais A, Bacq Y, Bernuau J, Martinot M, Auperin A, Boyer N, et al. Decrease in serum ALT and increase in serum HCV RNA during pregnancy in women with chronic hepatitis C. J Hepatol. 2000;32(2):293–9.CrossRefPubMed
18.
go back to reference Sarin SK, Kumar M, Shrivastava S, Sinha S, Pati NT. Influence of chronic HBV infection on pregnancy: a human model of maternofetal virus host interactions. Gastroenterology. 2011;141(4):1522–5.CrossRefPubMed Sarin SK, Kumar M, Shrivastava S, Sinha S, Pati NT. Influence of chronic HBV infection on pregnancy: a human model of maternofetal virus host interactions. Gastroenterology. 2011;141(4):1522–5.CrossRefPubMed
19.
go back to reference Nguyen G, Garcia RT, Nguyen N, Trinh H, Keeffe EB, et al. Clinical course of hepatitis B virus infection during pregnancy. Aliment Pharmacol Ther. 2009;29(7):755–64.CrossRefPubMed Nguyen G, Garcia RT, Nguyen N, Trinh H, Keeffe EB, et al. Clinical course of hepatitis B virus infection during pregnancy. Aliment Pharmacol Ther. 2009;29(7):755–64.CrossRefPubMed
20.
go back to reference Soderstrom A, Norkrans G, Lindh M. Hepatitis B virus DNA during pregnancy and post partum: aspects on vertical transmission. Scand J Infect Dis. 2003;35(11–12):814–9.CrossRefPubMed Soderstrom A, Norkrans G, Lindh M. Hepatitis B virus DNA during pregnancy and post partum: aspects on vertical transmission. Scand J Infect Dis. 2003;35(11–12):814–9.CrossRefPubMed
21.
go back to reference Liu J, Bi Y, Xu C, Liu L, Xu B, Chen T, et al. Kinetic changes of viremia and viral antigens of hepatitis B virus during and after pregnancy. Medicine (Baltimore). 2015;94(45):e2001.CrossRef Liu J, Bi Y, Xu C, Liu L, Xu B, Chen T, et al. Kinetic changes of viremia and viral antigens of hepatitis B virus during and after pregnancy. Medicine (Baltimore). 2015;94(45):e2001.CrossRef
22.
go back to reference Hu Y, Feng Z, Liu J, Chen J, Zhang S, Zhou YH. Virological determinants of spontaneous postpartum e antigen seroconversion and surface antigen seroclearance in pregnant women infected with hepatitis B virus. Arch Med Res. 2016;47(3):207–13.CrossRefPubMed Hu Y, Feng Z, Liu J, Chen J, Zhang S, Zhou YH. Virological determinants of spontaneous postpartum e antigen seroconversion and surface antigen seroclearance in pregnant women infected with hepatitis B virus. Arch Med Res. 2016;47(3):207–13.CrossRefPubMed
23.
go back to reference Tian Q, Jia J. Hepatitis B virus genotypes: epidemiological and clinical relevance in Asia. Hepatol Int. 2016;10(6):854–60.CrossRefPubMed Tian Q, Jia J. Hepatitis B virus genotypes: epidemiological and clinical relevance in Asia. Hepatol Int. 2016;10(6):854–60.CrossRefPubMed
24.
go back to reference Ott JJ, Stevens GA, Wiersma ST. The risk of perinatal hepatitis B virus transmission: hepatitis B e antigen (HBeAg) prevalence estimates for all world regions. BMC Infect Dis. 2012;12:131.CrossRefPubMedPubMedCentral Ott JJ, Stevens GA, Wiersma ST. The risk of perinatal hepatitis B virus transmission: hepatitis B e antigen (HBeAg) prevalence estimates for all world regions. BMC Infect Dis. 2012;12:131.CrossRefPubMedPubMedCentral
25.
go back to reference Sun KX, Li J, Zhu FC, Liu JX, Li RC, Zhai XJ, et al. A predictive value of quantitative HBsAg for serum HBV DNA level among HBeAg-positive pregnant women. Vaccine. 2012;30(36):5335–40.CrossRefPubMed Sun KX, Li J, Zhu FC, Liu JX, Li RC, Zhai XJ, et al. A predictive value of quantitative HBsAg for serum HBV DNA level among HBeAg-positive pregnant women. Vaccine. 2012;30(36):5335–40.CrossRefPubMed
26.
go back to reference Wen WH, Chang MH, Zhao LL, Ni YH, Hsu HY, Wu JF, 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.CrossRefPubMed Wen WH, Chang MH, Zhao LL, Ni YH, Hsu HY, Wu JF, 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.CrossRefPubMed
27.
go back to reference Lynge Nilsson L, Djurisic S, Hviid TV. Controlling the immunological crosstalk during conception and pregnancy: HLA-G in reproduction. Front Immunol. 2014;5:198.CrossRefPubMedPubMedCentral Lynge Nilsson L, Djurisic S, Hviid TV. Controlling the immunological crosstalk during conception and pregnancy: HLA-G in reproduction. Front Immunol. 2014;5:198.CrossRefPubMedPubMedCentral
28.
go back to reference Mellor AL, Munn DH. IDO expression by dendritic cells: tolerance and tryptophan catabolism. Nat Rev Immunol. 2004;4(10):762–74.CrossRefPubMed Mellor AL, Munn DH. IDO expression by dendritic cells: tolerance and tryptophan catabolism. Nat Rev Immunol. 2004;4(10):762–74.CrossRefPubMed
29.
go back to reference Beagley KW, Gockel CM. Regulation of innate and adaptive immunity by the female sex hormones oestradiol and progesterone. FEMS Immunol Med Microbiol. 2003;38(1):13–22.CrossRefPubMed Beagley KW, Gockel CM. Regulation of innate and adaptive immunity by the female sex hormones oestradiol and progesterone. FEMS Immunol Med Microbiol. 2003;38(1):13–22.CrossRefPubMed
30.
go back to reference Kalvatchev Z, Slavov S, Shtereva M, Savova S. Reactivation of polyomavirus hominis 1 (BKV) during pregnancy and the risk of mother-to-child transmission. J Clin Virol. 2008;43(3):328–9.CrossRefPubMed Kalvatchev Z, Slavov S, Shtereva M, Savova S. Reactivation of polyomavirus hominis 1 (BKV) during pregnancy and the risk of mother-to-child transmission. J Clin Virol. 2008;43(3):328–9.CrossRefPubMed
31.
go back to reference Hernández-Girón C, Smith JS, Lorincz A, Lazcano E, Hernández-Avila M, Salmerón J. High-risk human papillomavirus detection and related risk factors among pregnant and nonpregnant women in Mexico. Sex Transm Dis. 2005;32(10):613–8.CrossRefPubMed Hernández-Girón C, Smith JS, Lorincz A, Lazcano E, Hernández-Avila M, Salmerón J. High-risk human papillomavirus detection and related risk factors among pregnant and nonpregnant women in Mexico. Sex Transm Dis. 2005;32(10):613–8.CrossRefPubMed
Metadata
Title
Comparison of hepatitis B viral loads and viral antigen levels in child-bearing age women with and without pregnancy
Authors
Chenyu Xu
Jingli Liu
Lanhua Liu
Yongchun Bi
Biyun Xu
Jie Chen
Biao Xu
Tingmei Chen
Yali Hu
Yi-Hua Zhou
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2018
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-018-1932-9

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