Mother Infant Transmission of Hepatits B Virus in Pakistan

Abstract

Vertical transmission of hepatitis B from carries mothers t their infants occurs very early I life infection of hepatitis B leads to chronic carrier stats. Carrier infants may gradually develop hepatitis as they grow up., ultimately 25-30% of such children may die of primary liver cancer oftenwith underlying cirrhosis. HBs Ag carrier rate in infancy plays an important role in HBV epidemiology in maintaining a reservoir of the virus in community. The purpose of the study was to determine the prevalence of hepatitis in women of child bearing age and the rate of transmission of HBV from carrier mothers to their infants. A total of 6.225 expectant mothers were screened for HBsAg. 4% had HBsAg positive. 150 such mother/ infant pairs were studied. The delivered infants right up till 18 mothers 40(80%) transmitted HBeAg to the infants and by the end of 18 months of follow up 4 % developed Hepatitis with HBeAg positive. Out of 60 mothers with Anti-HBe positivity (60%)transmitted (non infections anti HBe) to the infant at the end of follow up 2.5 5 developed anti HBs and the rest had lost the maternal antibodies. In 150 mother/ infant control pairs 75 had Anti-HBs. They transmitted anti-HBs. Out of 75 HBV negative control group mothers. 3.7% had HBeAg in cord blood at the end they developed anti-HBs. The rest of infants were negative for HBV .During the study period 10 children under 5 years of age were referred with HBsAg positive. Their contacts were studied for HBV markers. In all the cases either of the parents were positive for HBsAg and HBeAg. Conclusions drawn from the study show that : Transplacental transmission of HBV is one of the causes of Hepatitis B in infants. About 4% children born to HBsAg and HBe Ag mother carry the virus and developed the disease. Infants born to HBeAg positive mothers are at a great risk of acquiring hepatitis B. Such children must get vaccination as early as possible. Passively transmitted anti HBc in infants confers protection until the immune system of the infants confers protecting antibodies against (6-12 months) hepatitis. Hepatitis B in children under 5 years of age appears to be contact associated. In case found positive HBsAg with. Liver disease either of the parents were found positive for HBsAg. As children are more closed to mothers. The risk of infection may be protected by immunization against hepatitis B.