Evaluation On Protective Efficacy And Analysis On Influencing Factors In Preventing Mother-to-infant Transmission Of Hepatitis B Virus--study About Interruption Of Hepatitis B Vaccines And Hepatitis B Immune Globulin

Objectives:To evaluate the protective efficacy in preventing mother-to-infant transmission of Hepatitis B Virus(HBV) with immunization of Recombinant Yeast Hepatitis B vaccines(HepB)(10μg) and HepB(10μg)combination with Hepatitis B immune globulin(HBIG), And to explore the factors in preventing mother-to-infant transmission of HBV.Methods:This study was a prospective cohort study. In Yunnan Province, we selected mothers whose infants were born from January through February2011, and HBsAg were positive when they were pregnant or child-bearing.The newborns were divided into groups A and B, which infants in groups A were immuned with HepB within24hours after their birth, and infants in groups B were immuned with HepB and HBIG within24hours after their birth. The regular schedule of HepB immunization was0,1st, and6th month with the dose was10μg. The information about HBV infection of mothers and infants, and recodes of HepB immunization of infants, were collected by the fixed questionnaires. The Serum of the children in cohort would be collected in one month after the full dose immunization following a laboratory test of the HBV infection indicators. The end point of this research was on December31,2011. Protective efficacy was estimated using series of formulas. The factors, such as mother's HBV infecting status, delivery mode, breast feeding, and immuned with HepB and HBIG or with HepB only, were analysed with Logistic regression.Results:For mothers whose both HBsAg and HBeAg were positive, the HBsAg positive rate and the protective rate was14.1%and83.4%for the infants vaccinated with HBIG, and5.1%and94%for the infants vaccinated without HBIG (χ2=4.422,P value=0.035).For mothers with only the HBsAg positive,the difference was no significant between the group combination with HBIG and without HBIG(continuity correctionχ2=1.287,P value=0.257). For the children vaccinated with HepB only, the HBsAg positive rate and the protective rate was14.1%and83.4%for the infants whose mother both HBsAg and HBeAg positive, and was4.1%and89.7%for the mother only HBsAg positive (χ2=4.227,P value=0.04). For the children vaccinated with HepB and HBIG, the difference was no significant between the mother both HBsAg and HBeAg were positive and only HBsAg (continuity correctionχ2=3.28, P value=0.07).Results from multi-factors analysis showed that mother's HBV infecting status(OR=5.01,95%CI:1.714-14.669)and combination with HBIG (OR=3.605,95%CI:1.385～9.381) were the important influencing factors of recombinant yeastderived HepB in preventing mother-to-infant transmission of HBV. While HBIG inoculation in pregnant women, delivery mode, level of hospital, breast feeding and gender were not the factors.Conclusions:For mothers both HBsAg and HBeAg positive, the protective efficacy are better for the infants vaccinated with HepB and HBIG, while the protective efficacy had no difference for the infants whose mother was only HBsAg positive. For infants vaccinated with only HepB, they had high risk whose mother both HBsAg and HBeAg were positive.