肿瘤预防与治疗2025，Vol.38Issue(12)：1077-1082,6.DOI:10.3969/j.issn.1674-0904.2025.12.006
HBsAg阳性母亲新生儿联合免疫后anti-HBs水平及影响因素:HBV-HCC的一级预防
Anti-HBs Levels and Influencing Factors in Infants of HBsAg-Positive Mothers following Combined Immunoprophylaxis:Primary Prevention of HBV-HCC
Yan Lina 1Fu Yanhong 1Zhang Lin 1Xie Xiuqin1
作者信息
- 1. @@@Department of Neonatology(Yan Lina,Fu Yanhong,Zhang Lin),Department of Obstetrics(Xie Xiuqin),the People's Hospital of Jianyang City,Chengdu 641400,Sichuan,China
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摘要
Abstract
Objective:This study aimed to investigate the serum levels of hepatitis B surface antibody(anti-HBs)and its influencing factors in infants born to hepatitis B surface antigen(HBsAg)-positive mothers,following immunization with both hepatitis B immunoglobulin(HBIG)and the hepatitis B vaccine.The findings are expected to inform strategies for preventing the mother-to-child transmission of hepatitis B virus(HBV)and for the primary prevention of HBV-associated hepatocellular carcinoma(HBV-HCC).Methods:A total of 228 neonates born to HBsAg-positive mothers were retrospectively recruited from the Department of Neonatology at Jianyang Peo-ple's Hospital between January 2022 and December 2023.All neonates underwent combined immunoprophylaxis with HBIG and the hepatitis B vaccine within 12 hours of birth.They were then stratified into two groups based on their anti-HBs levels within 24 hours post-immunization:a low-response group(anti-HBs<100 IU/L)and a high-response group(anti-HBs≥100 IU/L).Maternal and infant clinical data were collected for both groups.Univariate and multivariable logistic regression analyses were employed to identify factors associated with the immune response in infants following combined immunoprophy-laxis.Results:Following combined immunoprophylaxis,the anti-HBs levels measured within 24 hours showed that 226 new-borns(99.12%)had anti-HBs>10 IU/L,and 185(81.14%)had anti-HBs>100 IU/L.Univariate analysis identified several factors significantly associated with the low immune response group(all P<0.05),including:maternal age>35 years,pre-pregnancy BMI>24.0 kg/m2,maternal HBV-DNA>106 IU/mL before delivery,maternal HBeAg positivity be-fore delivery,and higher newborn birth weight.Multivariable logistic regression identified pre-pregnancy BMI>24.0 kg/m2(OR=0.372,95%CI:0.164～0.844)and higher birth weight(OR=0.167,95%CI:0.078～0.355)as significant factors for lower anti-HBs levels,while maternal HBeAg positivity(OR=6.146,95%CI:2.161～17.482)was associat-ed with higher anti-HBs levels after combined immunoprophylaxis.At the 7-month follow-up,all infants were serum HBsAg-negative with no cases of chronic HBV infection.Conclusion:Pre-pregnancy BMI>24.0 kg/m2 and higher newborn birth weight were independently associated with low anti-HBs levels after combined immunoprophylaxis,whereas maternal HBeAg positivity before delivery was associated with high anti-HBs levels.The combined immunoprophylaxis effectively prevented mother-to-child transmission of HBV,and consequently future HBV-HCC,irrespective of the specific anti-HBs levels elicited in newborns.关键词
乙型肝炎病毒/母婴传播/主动免疫/被动免疫/一级预防/肝癌Key words
Hepatitis B virus/Mother-to-child transmission/Active immunization/Passive immunization/Primary pre-vention/Hepatocellular carcinoma分类
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Yan Lina,Fu Yanhong,Zhang Lin,Xie Xiuqin..HBsAg阳性母亲新生儿联合免疫后anti-HBs水平及影响因素:HBV-HCC的一级预防[J].肿瘤预防与治疗,2025,38(12):1077-1082,6.
