Mechanisms of maternal-fetal transmission of hepatitis B virus.

In a prospective study of maternal-fetal transmission of hepatitis B virus in 125 healthy mothers who were carriers of hepatitis B surface antigen (HBsAg), preliminary results showed that the most important determinant in such transmission was the presence of hepatitis B e antigen in the mother. HBsAg was detectable by solid-phase radioimmunoassay in 33% of amniotic fluid samples, 50% of cord blood samples, 71% of breast milk samples, and 95.3% of samples of gastric contents from newborns. The presence of HBsAg in gastric aspirate from the infants immediately after birth in almost all cases suggests a universal mechanism of infection by the oral route during delivery. In light of these findings, precautions such as possible elective cesarean section, routine gastric aspiration of the newborn, avoidance of breast-feeding, etc., should be taken to avoid perinatal transmission.

[1]  R. Purcell,et al.  Type B hepatitis: the infectivity of blood positive for e antigen and DNA polymerase after accidental needlestick exposure. , 1976, The New England journal of medicine.

[2]  D. Bradley,et al.  "e" Antigen, Dane particles, and serum DNA polymerase activity in HBsAg carriers. , 1976, Annals of internal medicine.

[3]  J. Maynard,et al.  e ANTIGEN AND ANTI-e IN HBsAg CARRIERS , 1975, The Lancet.

[4]  R. Beasley,et al.  EVIDENCE AGAINST BREAST-FEEDING AS A MECHANISM FOR VERTICAL TRANSMISSION OF HEPATITIS B , 1975, The Lancet.

[5]  Y. Miyakawa,et al.  Hepatitis B surface antigen in the serum of infants after deliver from asymptomatic carrier mothers. , 1975, The Journal of pediatrics.

[6]  R. Beasley,et al.  Vertical transmission of hepatitis B antigen in Taiwan. , 1975, The New England journal of medicine.

[7]  J. Hoofnagle,et al.  TRANSPLACENTAL TRANSMISSION OF HEPATITIS-B VIRUS BY SYMPTOM-FREE CHRONIC CARRIER MOTHERS , 1975 .

[8]  A. Levin,et al.  Hepatitis B antigen, antigen subtypes, and hepatitis B antibody in normal subjects and patients with liver disease. , 1975, Bulletin of the World Health Organization.

[9]  M. Imai,et al.  Haemagglutination inhibition assay of the common determinants and subspecificities of Australia antigen. , 1974, Immunology.

[10]  C. Linnemann,et al.  HBAg IN BREAST MILK , 1974 .

[11]  J. Mosley,et al.  Factors influencing neonatal infection by hepatitis B virus. , 1973, Gastroenterology.

[12]  Magnius Lo,et al.  New Specificities in Australia Antigen Positive Sera Distinct from the Le Bouvier Determinants , 1972 .

[13]  M. Mikkelsen,et al.  Hepatitis associated antigen (HAA) in pregnant women and their newborn infants. , 1972, American journal of diseases of children.

[14]  S. Krugman,et al.  Viral hepatitis. New light on an old disease. , 1970, JAMA.

[15]  D. Zarou,et al.  THE TRANSMISSION OF CHROMIUM-51 TAGGED MATERNAL ERYTHROCYTES FROM MOTHER TO FETUS. , 1964, American journal of obstetrics and gynecology.