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Occult hepatitis B virus infection in children born to HBsAg-positive mothers after neonatal passive-active immunoprophylaxis

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Abstract

Background

Occult hepatitis B virus infection (OBI) is a well-recognized clinical entity characterized by the detection of HBV DNA in serum and/or liver in the absence of detectable HBsAg. Diagnosis of OBI requires a sensitive HBV DNA assay.

Aim

We aimed at determining the frequency of OBI in infants, born to HBsAg-positive mothers, who received immunoprophylaxis at birth.

Methods

Sixty-four infants and children, born to HBsAg-positive mothers, who received hepatitis B immunoglobulin and HBV vaccine within 48 h after birth, were tested for HBV serological profile and HBV DNA by real-time PCR at least 1 month after last dose of HBV vaccine and not before 6 months of age.

Results

The median age of the studied infants and children was 8 months, ranging from 6 to 132 months; 54.7 % were females. HBV DNA was detected in 2 infants. One case had OBI; she was negative for HBsAg, anti-HBc total, HBeAg and was positive for anti-HBs (titer 267 mIU/mL) with low level of viremia (HBV DNA 1.13 x 103 IU/mL). Another infant showed immunoprophylaxis failure with positive HBsAg, anti-HBc total, HBeAg, negative anti-HBe and anti-HBs; HBV viral load was 1.7 × 108 IU/mL. Both mothers were HBsAg and HBeAg-positive.

Conclusion

OBI may occur in infants born to HBsAg-positive mothers despite the receipt of immunoprophylaxis. OBI was detected in a low frequency in the present study. Anti-HBs positivity does not exclude OBI.

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Acknowledgments

This work has been funded partially by the National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt.

Conflict of interest

No conflict of interest to declare.

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Authors and Affiliations

  1. Department of Pediatrics, National Hepatology and Tropical Medicine Research Institute, 7101 El-Kahera Buildings, El-Mokattam, Cairo, 11415, Egypt

    Hanan Foaud

  2. Department of Internal Medicine and Hepatology, National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt

    Sahar Maklad

  3. Department of Clinical Chemistry, National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt

    Faten Mahmoud

  4. Department of Pediatrics, Kasr Alainy Medical School, Cairo University, Cairo, Egypt

    Hanaa El-Karaksy

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  1. Hanan Foaud
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  2. Sahar Maklad
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Correspondence to Hanan Foaud.

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Foaud, H., Maklad, S., Mahmoud, F. et al. Occult hepatitis B virus infection in children born to HBsAg-positive mothers after neonatal passive-active immunoprophylaxis. Infection 43, 307–314 (2015). https://doi.org/10.1007/s15010-015-0733-6

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