The role of transplacental hepatitis B core antibody in the mother-to-infant transmission of hepatitis B virus

Aims/Methods: To investigate the influence of transplacental hepatitis B core antibody (anti-HBc) on perinatal hepatitis B virus (HBV) transmission, we studied the anti-HBc titers in 294 mother-neonate pairs. Results: The anti-HBc titer was highest (105.13±0.80 to 104.36±0.97 in mothers, 105.13±0.76 to 105.52±0.98 in infants) in the 200 hepatitis B e antigen (HBeAg) positive hepatitis B surface antigen (HBsAg) carrier mothers and their infants, second highest (104.51±0.76 and 104.68±0.76) in the 60 HBeAg-negative HBsAg carrier mothers and their infants, and lowest (103.11±0.76 and 103.24±0.83) in the 34 non-carrier mothers and their infants (p<0.05). One hundred and ninety-two infants of HBeAg-positive carrier mothers received hepatitis B immunoglobulin as well as hepatitis B vaccines, and were followed prospectively from birth. Ten infants became HBsAg carriers, and their mothers had significantly lower anti-HBc titers than those of the mothers of 182 infants who did not become carriers (p=0.003), while maternal serum hepatitis B virus DNA levels (29.9±23.6 versus 39.9±58.1 pg/10 ml) did not differ in those two gruops (p>0.25). The same trend was observed in the infantsʹ anti-HBc titers in those two groups (p=0.0006). Conclusions: The association of lower anti-HBc titers in HBeAg-positive carrier mother-infant pairs and the development of carrier status in the infants suggests a positive role of anti-HBc in the modulation of mother-to-infant transmission of HBV. A high maternal anti-HBc level in serum may be a negative predictor of immunoprophylaxis failure in high-risk infants.