Mother-to-infant transmission of hepatitis B virus(HBV)is a main cause of chronic HBV infection.Maternal high HBV DNA level or positive hepatitis B e antigen(HBeAg)is the major risk factor for the transmission.With re...Mother-to-infant transmission of hepatitis B virus(HBV)is a main cause of chronic HBV infection.Maternal high HBV DNA level or positive hepatitis B e antigen(HBeAg)is the major risk factor for the transmission.With recommended passive and active immunoprophylaxis,the transmission occurs in nearly 0 and 4-12%of infants born to HBV-infected mothers with negative and positive HBeAg,respectively.Therefore,pregnant women with negative HBeAg appear not requiring antiviral therapy to prevent mother-to-infant transmission of HBV.Recent studies demonstrated that oral antivirals(lamivudine,telbivudine,or tenofovir)in pregnant women with high viral load or positive HBeAg,starting from 28-32 weeks of gestation,together with neonatal immunoprophylaxis,can almost completely prevent the transmission,indicating that it does not require antiviral therapy before 28 weeks of gestation.Accumulated evidence showed that the antivirals may be stopped upon delivery,and the infants may receive breast feeding after birth.However,these issues,as well as HBV DNA threshold for antiviral therapy during pregnancy,optimal timing for start and discontinuation of antivirals,and the drug safety of fetuses/infants,require further investigations to optimize the antiviral therapy during pregnancy.The proof of safety of fetal exposure to antivirais needs more evidence,which can be achieved from the real-world data analysis.展开更多
BACKGROUND How to treat infantile hepatitis B virus(HBV)infection remains a controversial issue.The nucleoside analogue lamivudine(LAM)has been approved to treat children(2 to 17 years old)with chronic hepatitis B.Her...BACKGROUND How to treat infantile hepatitis B virus(HBV)infection remains a controversial issue.The nucleoside analogue lamivudine(LAM)has been approved to treat children(2 to 17 years old)with chronic hepatitis B.Here,we aimed to investigate the benefit of LAM treatment in infantile hepatitis B.CASE SUMMARY A 4-mo-old infant born to a hepatitis B surface antigen(HBsAg)-positive woman was found to be infected by HBV during a health checkup.Liver chemistry and HBV seromarker tests showed alanine aminotransferase of 106 U/L,HBsAg of 685.2 cut-off index,hepatitis B“e”antigen of 1454.0 cut-off index,and HBV DNA of>1.0×10^(9) IU/mL.LAM treatment(20 mg/d)was initiated,and after 19 mo,serum HBsAg was entirely cleared and hepatitis B surface antibody was present.The patient received LAM treatment for 2 years in total and has been followed for 3 years.During this period,serum hepatitis B surface antibody has been persistently positive,and serum HBV DNA was undetectable.CONCLUSION Early treatment of infantile hepatitis B with LAM could be safe and effective。展开更多
Background: Bonding disorders affect the growth and development of infants. In Japan, the Japanese version of the Mother-to-Infant Bonding Scale (MIBS-J) is widely used for early detection of bonding disorders. Repeat...Background: Bonding disorders affect the growth and development of infants. In Japan, the Japanese version of the Mother-to-Infant Bonding Scale (MIBS-J) is widely used for early detection of bonding disorders. Repeated use of a questionnaire has problems of reduced validity. In order to correctly detect bonding disorders at multiple time points, it is necessary to confirm the measurement invariance of the scale. Baba et al. reported that invariance of the MIBS-J factor structure could only be obtained by abridging the scale into three items. Purpose: The aim of this study was to 1) confirm the factor structure and measurement invariance of the MIBS-J between two measurement times and 2) to examine factors that can be used without being affected by measurement time in order to identify item that contribute to measure met invariance. Methods: We analysed the data of 1049 and 878 mothers with a neonate collected in two waves: 5 days (Wave 1) and 1 month postpartum (Wave 2). Exploratory and confirmatory factor analyses were conducted on the data randomly divided into two groups in each wave. Results: The three-item model (MIBS-J items 1, 6, and 8) was most accepted. Measurement invariance and structural invariance were confirmed in the model. This was consistent with Baba et al.’s model. Conclusion: The three MIBS-J items showed measurement invariance and structural invariance in Japanese mothers during 1 month postpartum.展开更多
OBJECTIVE: To study the relationship between the different replication status of hepatitis B virus (HBV) and mutations in the core promoter (CP) in mother and her child infected by mother-to-infant transmission. METHO...OBJECTIVE: To study the relationship between the different replication status of hepatitis B virus (HBV) and mutations in the core promoter (CP) in mother and her child infected by mother-to-infant transmission. METHODS: The core promoter was amplified by PCR and cloned into pGEM-T vector with the T-A choning technique. The recombinant plasmid pGEM-CP was confirmed by digestion with restriction enzyme Apa I and Sac I. Two clones were selected to be sequenced in each patient. RESULTS: Every pair of mother and child had same serotype and genotype and the homology of nucleotides encoding 'a' determinant was 98%-100%. The number of mutations in the core promoter of patients with a high replication status was less than that in those with a low replication status. Mutations were mainly distributed in basia core promoter (BCP) and the inbibitor region of Kunitz-type serine protease. This difference was not associated with mother or child. CONCLUSION: The different replication status of HBV is caused by mutations in the core promoter in mother and child infected hy mother-to-infant transmission and appears to be not associated with the status of development of the infection.展开更多
Objective To determine the hepatitis B immunoprophylactic failure rate in infants born to hepatitis B virus （HBV） infected mothers and to characterize HBV genes. Methods HBV-serological testing was conducted for pre...Objective To determine the hepatitis B immunoprophylactic failure rate in infants born to hepatitis B virus （HBV） infected mothers and to characterize HBV genes. Methods HBV-serological testing was conducted for pregnant women and infants. The complete genomes of 30 HBV isolates were sequenced, and genetic characteristics were analyzed using MEGA 5 software. Results The immunoprophylactic failure rate for infants who had completed the scheduled hepatitis B vaccination program was 5.76% （32/556）. High sequence homology （99.8%-100%） was observed in 8 of the 10 mother-infant pairs. We identified 19 subgenotype C2 strains, 9 subgenotype B2 strains, and 2 subgenotype Cl strains. Three serotypes were detected： adr （19/30）, adw （9/30）, and ayw （2/30）. The frequency of amino acid mutation of the ＇a＇ determinant region was 16.67% （5/30）, including that of Q129H, F134Y,S136Y, and G145E. We detected 67 amino acid mutations in the basal core promoter, precore, and core regions of the genome. Conclusion The immunoprophylactic failure rate in infants born to HBV-infected mothers is low in the regions of China examined during this study. Moreover, HBV mutation in the ＇a＇ determinant region could not account for immunoprophylactic failure for all infants.展开更多
Objective：To search for risk factors that affect mother-to-infant transmission of hepatitis B virus（HBV）. Methods：To obtain studies eligible for meta-analysis, China biological medicine discs and MEDLINE citations...Objective：To search for risk factors that affect mother-to-infant transmission of hepatitis B virus（HBV）. Methods：To obtain studies eligible for meta-analysis, China biological medicine discs and MEDLINE citations were surveyed. Mother HBV DNA or HBeAg positivity,neonate HBeAg positivity, mode of delivery, threatened abortion and threatened premature labor were processed with meta analysis. Criteria for selection of published studies for meta analysis were based on principle by Abdolmaleky HM. Odds ratio （OR） was calculated and summarized by fixed effect model or random-effects model using RevMan software. The heterogeneity of the group of ORs was assessed using an X^2 test. The significance of the pooled OR was determined by the u-test. The strength of association was assessed using the OR. An OR〉1. 0 indicated a positive association between the risk factor and neonate HBV infection. Results： After meta analysis of factors concerned, a significant association was found between the positivity of HBeAg in mother and neonate, of HBV DNA in mother peripheral serum, and HBV mother-to-infant transmission, with a pooled OR equal to 19.43 （95% CI=8. 77-43. 06）, 36.5 （95% CI= 19.85-67. 11）, and 36.5 （95 % CI= 19.85-67.11 ） respectively. Mode of delivery, threatened abortion and threatened premature labor proved not to be of risk factors on the mother-to-infant transmission of HBV. Conclusion： Mother HBV DNA or HBeAg positivity and neonate HBeAg positivity were proved to be of risk factors affecting the transmission of HBV from mother to fetal.展开更多
Aim: The aim of the present study was to examine associations among maternal stress level, general health, mother to infant bonding, maternal depression level, and mode of delivery. Methods: Mothers who delivered a si...Aim: The aim of the present study was to examine associations among maternal stress level, general health, mother to infant bonding, maternal depression level, and mode of delivery. Methods: Mothers who delivered a single baby at term were recruited with a total 435 mothers participating in the study. Outcome measures: Data were collected 6 months after delivery using General Health Questionnaire (GHQ-28), Mother-to-Infant Bonding Scale (MIBS), Edinburgh Postnatal Depression Scale (EPDS) as well as socio-demographic and medical information at 6 months. Additionally, salivary cortisol and chromogranin levels were determined. Results: The proportion of breast-feeding mothers in the vaginal delivery group (51.4%) was significantly higher than that of the cesarean section group (24%). GHQ-28 scores were significantly related to EPDS scores and MIBS scores (P Conclusion: Maternal general health is associated with maternal psychological health. These results suggest that the support of maternal health is important to maintain maternal psychological status and bonding to infants. Because EPDS scores were significantly worse in the planned cesarean section group (4.2 ± 3.3), careful management is needed of mothers who deliver by planned cesarean section.展开更多
基金This work was supported by the Science and Technology Department of Jiangsu Province(BK20161105)the National Natural Science Foundation of China(81672002),China.
文摘Mother-to-infant transmission of hepatitis B virus(HBV)is a main cause of chronic HBV infection.Maternal high HBV DNA level or positive hepatitis B e antigen(HBeAg)is the major risk factor for the transmission.With recommended passive and active immunoprophylaxis,the transmission occurs in nearly 0 and 4-12%of infants born to HBV-infected mothers with negative and positive HBeAg,respectively.Therefore,pregnant women with negative HBeAg appear not requiring antiviral therapy to prevent mother-to-infant transmission of HBV.Recent studies demonstrated that oral antivirals(lamivudine,telbivudine,or tenofovir)in pregnant women with high viral load or positive HBeAg,starting from 28-32 weeks of gestation,together with neonatal immunoprophylaxis,can almost completely prevent the transmission,indicating that it does not require antiviral therapy before 28 weeks of gestation.Accumulated evidence showed that the antivirals may be stopped upon delivery,and the infants may receive breast feeding after birth.However,these issues,as well as HBV DNA threshold for antiviral therapy during pregnancy,optimal timing for start and discontinuation of antivirals,and the drug safety of fetuses/infants,require further investigations to optimize the antiviral therapy during pregnancy.The proof of safety of fetal exposure to antivirais needs more evidence,which can be achieved from the real-world data analysis.
基金Supported by National Natural Science Foundation of China(General Program),No.82070610.
文摘BACKGROUND How to treat infantile hepatitis B virus(HBV)infection remains a controversial issue.The nucleoside analogue lamivudine(LAM)has been approved to treat children(2 to 17 years old)with chronic hepatitis B.Here,we aimed to investigate the benefit of LAM treatment in infantile hepatitis B.CASE SUMMARY A 4-mo-old infant born to a hepatitis B surface antigen(HBsAg)-positive woman was found to be infected by HBV during a health checkup.Liver chemistry and HBV seromarker tests showed alanine aminotransferase of 106 U/L,HBsAg of 685.2 cut-off index,hepatitis B“e”antigen of 1454.0 cut-off index,and HBV DNA of>1.0×10^(9) IU/mL.LAM treatment(20 mg/d)was initiated,and after 19 mo,serum HBsAg was entirely cleared and hepatitis B surface antibody was present.The patient received LAM treatment for 2 years in total and has been followed for 3 years.During this period,serum hepatitis B surface antibody has been persistently positive,and serum HBV DNA was undetectable.CONCLUSION Early treatment of infantile hepatitis B with LAM could be safe and effective。
文摘Background: Bonding disorders affect the growth and development of infants. In Japan, the Japanese version of the Mother-to-Infant Bonding Scale (MIBS-J) is widely used for early detection of bonding disorders. Repeated use of a questionnaire has problems of reduced validity. In order to correctly detect bonding disorders at multiple time points, it is necessary to confirm the measurement invariance of the scale. Baba et al. reported that invariance of the MIBS-J factor structure could only be obtained by abridging the scale into three items. Purpose: The aim of this study was to 1) confirm the factor structure and measurement invariance of the MIBS-J between two measurement times and 2) to examine factors that can be used without being affected by measurement time in order to identify item that contribute to measure met invariance. Methods: We analysed the data of 1049 and 878 mothers with a neonate collected in two waves: 5 days (Wave 1) and 1 month postpartum (Wave 2). Exploratory and confirmatory factor analyses were conducted on the data randomly divided into two groups in each wave. Results: The three-item model (MIBS-J items 1, 6, and 8) was most accepted. Measurement invariance and structural invariance were confirmed in the model. This was consistent with Baba et al.’s model. Conclusion: The three MIBS-J items showed measurement invariance and structural invariance in Japanese mothers during 1 month postpartum.
基金This study was supported by a grant from the National Natural Science Foundation of China (No. 39630280).
文摘OBJECTIVE: To study the relationship between the different replication status of hepatitis B virus (HBV) and mutations in the core promoter (CP) in mother and her child infected by mother-to-infant transmission. METHODS: The core promoter was amplified by PCR and cloned into pGEM-T vector with the T-A choning technique. The recombinant plasmid pGEM-CP was confirmed by digestion with restriction enzyme Apa I and Sac I. Two clones were selected to be sequenced in each patient. RESULTS: Every pair of mother and child had same serotype and genotype and the homology of nucleotides encoding 'a' determinant was 98%-100%. The number of mutations in the core promoter of patients with a high replication status was less than that in those with a low replication status. Mutations were mainly distributed in basia core promoter (BCP) and the inbibitor region of Kunitz-type serine protease. This difference was not associated with mother or child. CONCLUSION: The different replication status of HBV is caused by mutations in the core promoter in mother and child infected hy mother-to-infant transmission and appears to be not associated with the status of development of the infection.
基金supported by the Chinese Twelfth Five-Year Plan,a major science and technology program for hepatitis(Grant Number:2012ZX10002001)
文摘Objective To determine the hepatitis B immunoprophylactic failure rate in infants born to hepatitis B virus （HBV） infected mothers and to characterize HBV genes. Methods HBV-serological testing was conducted for pregnant women and infants. The complete genomes of 30 HBV isolates were sequenced, and genetic characteristics were analyzed using MEGA 5 software. Results The immunoprophylactic failure rate for infants who had completed the scheduled hepatitis B vaccination program was 5.76% （32/556）. High sequence homology （99.8%-100%） was observed in 8 of the 10 mother-infant pairs. We identified 19 subgenotype C2 strains, 9 subgenotype B2 strains, and 2 subgenotype Cl strains. Three serotypes were detected： adr （19/30）, adw （9/30）, and ayw （2/30）. The frequency of amino acid mutation of the ＇a＇ determinant region was 16.67% （5/30）, including that of Q129H, F134Y,S136Y, and G145E. We detected 67 amino acid mutations in the basal core promoter, precore, and core regions of the genome. Conclusion The immunoprophylactic failure rate in infants born to HBV-infected mothers is low in the regions of China examined during this study. Moreover, HBV mutation in the ＇a＇ determinant region could not account for immunoprophylactic failure for all infants.
文摘Objective：To search for risk factors that affect mother-to-infant transmission of hepatitis B virus（HBV）. Methods：To obtain studies eligible for meta-analysis, China biological medicine discs and MEDLINE citations were surveyed. Mother HBV DNA or HBeAg positivity,neonate HBeAg positivity, mode of delivery, threatened abortion and threatened premature labor were processed with meta analysis. Criteria for selection of published studies for meta analysis were based on principle by Abdolmaleky HM. Odds ratio （OR） was calculated and summarized by fixed effect model or random-effects model using RevMan software. The heterogeneity of the group of ORs was assessed using an X^2 test. The significance of the pooled OR was determined by the u-test. The strength of association was assessed using the OR. An OR〉1. 0 indicated a positive association between the risk factor and neonate HBV infection. Results： After meta analysis of factors concerned, a significant association was found between the positivity of HBeAg in mother and neonate, of HBV DNA in mother peripheral serum, and HBV mother-to-infant transmission, with a pooled OR equal to 19.43 （95% CI=8. 77-43. 06）, 36.5 （95% CI= 19.85-67. 11）, and 36.5 （95 % CI= 19.85-67.11 ） respectively. Mode of delivery, threatened abortion and threatened premature labor proved not to be of risk factors on the mother-to-infant transmission of HBV. Conclusion： Mother HBV DNA or HBeAg positivity and neonate HBeAg positivity were proved to be of risk factors affecting the transmission of HBV from mother to fetal.
文摘Aim: The aim of the present study was to examine associations among maternal stress level, general health, mother to infant bonding, maternal depression level, and mode of delivery. Methods: Mothers who delivered a single baby at term were recruited with a total 435 mothers participating in the study. Outcome measures: Data were collected 6 months after delivery using General Health Questionnaire (GHQ-28), Mother-to-Infant Bonding Scale (MIBS), Edinburgh Postnatal Depression Scale (EPDS) as well as socio-demographic and medical information at 6 months. Additionally, salivary cortisol and chromogranin levels were determined. Results: The proportion of breast-feeding mothers in the vaginal delivery group (51.4%) was significantly higher than that of the cesarean section group (24%). GHQ-28 scores were significantly related to EPDS scores and MIBS scores (P Conclusion: Maternal general health is associated with maternal psychological health. These results suggest that the support of maternal health is important to maintain maternal psychological status and bonding to infants. Because EPDS scores were significantly worse in the planned cesarean section group (4.2 ± 3.3), careful management is needed of mothers who deliver by planned cesarean section.
