Few data are available regarding the progression of liver disease and therapeutic efficacy in chronic hepatitis B virus (HBV) carriers infected by mother-to-child transmission (MTCT). This study aimed to investigate these two aspects by comparing the adult chronic HBV carriers in MTCT group with those in horizontal transmission group.
The 683 adult chronic HBV patients qualified for liver biopsy including 191 with MTCT and 492 with horizontal transmission entered the multi-center prospective study from October 2013 to May 2016. Biopsy results from 217 patients at baseline and 78 weeks post antiviral therapy were collected.
Patients infected by MTCT were more likely to have e antigen positive (68.6% vs. 58.2%, χ2 = –2.491, P = 0.012) than those with horizontal transmission. However, in patients with MTCT, levels of alkaline phosphatase (ALP) (P = 0.031), Fibroscan (P = 0.013), N-terminal propeptide of Type III procollagen (PIIINP) (P = 0.014), and Laminin (LN) (P = 0.006) were high, in contrast to the patients with horizontal transmission for whom the levels of albumin (ALB) (P = 0.041), matrix metalloproteinase-3 (MMP-3) (P = 0.001) were high. The 47.2% of patients with MTCT and 36.8% of those with horizontal transmission had significant liver fibrosis (P = 0.013). Following antiviral therapy for 78 weeks, 21.2% and 38.0% patients with MTCT and horizontal transmission acquired hepatitis B e antigen (HBeAg) clearance, respectively (P = 0.043), and the virological response rates were 54.7% and 74.1% in the MTCT and horizontal groups, respectively (P = 0.005). MTCT was a risk factor for HBeAg clearance and virological response.
Adult patients with MTCT were more prone to severe liver diseases, and the therapeutic efficacy was relatively poor, which underlined the importance of earlier, long-term treatment and interrupting perinatal transmission.
1Department of Infectious Diseases, Center for Liver Disease, Peking University First Hospital, Beijing 100034, China
2Department of Infectious Diseases, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
3Department of Infectious Diseases, China-Japan Friendship Hospital, Beijing 100029, China
4Department of Infectious Diseases, The Third Affiliated Hospital Sun Yat-Sen University, Guangzhou, Guangdong 510000, China
5Department of Infectious Diseases, South West Hospital Affiliated to Third Military Medical University, Chongqing 400038, China
6Department of Hepatology, Shanghai Public Health Clinical Center, Fudan University, Shanghai 200083, China
7Department of Infectious Diseases, Second Affiliated Hospital of Chongqing Medical University, Chongqing 404000, China
8Department of Infectious Diseases, Xinxiang Medical University Third Hospital, Xinxiang, Henan 453003, China
9Department of Infectious Diseases, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi 530021, China
10Department of Infectious Diseases, Di Tan Hospital Affiliated to Capital Medical University, Beijing 100015, China
11Department of Infectious Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200090, China
12Department of Infectious Diseases, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 211166, China
13Department of Infectious Diseases, Yantai City Hospital for Infectious Disease, Yantai, Shandong 264001, China
14Shenzhen Key Laboratory of Pathogen and Immunity, State Key Discipline of Infectious Disease, Shenzhen Third People's Hospital, Shenzhen, Guangdong 518034, China
15The Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Zhejiang University, Hangzhou, Zhejiang 310085, China
16Department of Infectious Diseases, Peking University International Hospital, Beijing 102206, China.
Correspondence to: Prof. Hong Zhao, Department of Infectious Diseases. Center for Liver Diseases, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing 100034, ChinaE-Mail: firstname.lastname@example.org
How to cite this article: Li J, Dong XQ, Wu Z, Ma AL, Xie SB, Zhang XQ, Zhang ZQ, Zhang DZ, Zhao WF, Zhang G, Cheng J, Xie Q, Li J, Zou ZQ, Liu YX, Wang GQ, Zhao H; China Hepatitis B Related Fibrosis Assessment Research Group. Unsatisfying antiviral therapeutic effect in patients with mother-to-child transmissed chronic hepatitis B virus infection: a prospective multi-center clinical study. Chin Med J 2019;00:00–00. doi: 10.1097/CM9.0000000000000522
Received 2 June, 2019
Jun Li and Xiao-Qin Dong contributed equally to this work.
Online date: November 12, 2019
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