Khalida Kazmi, Ghafoor A, Waheed Qureshi A.
Mother-infant transmission of hepatitis B in Pakistan.
Pak J Med Res Jan ;42(4):152-6.

Background: Prenatal transmission from Hepatitis B infected mothers to their offspring may be the most important mechanism for the maintenance of HBV carriers in the world. Objectives: 1. To determine the prevalence of Hepatitis B carrier rate in women of childbearing age. 2. To find out the route of transmission of Hepatitis B from mother to infants. 3. To identify possible risk factors of HBV infection from mothers to infants. Design: We screened pregnant females for HBs Ag attending the Gynae OPD of hospitals of Rawalpindi / Islamabad. The mothers found positive for HBs Ag were registered for the study and were further tested for HBc Ag, Anti HBe, HBc and Anti HBs. The cord blood of the delivered infant was taken and tested for HBV markers and the infants were followed for 18 months for the status of HBV. Results: Four percent of the mothers had HBs Ag positive. 150 mother infants pairs were followed. 90% of HBe Ag positive mothers transmitted HBe Ag to the infants at the end of follow-up 4.1 % developed Hepatitis B. 83% of anti HBe positive mothers transmitted the markers to their infants at the end only 3.3% developed anti HBs. Among the anti-HBs positive control group 67 % of the infants had transplacental anti-HBs at the end of follow-up 13 % developed anti-HBs. Among the HBV Negative group the 1.3 % of the infants had anti-HBc Positive an card blood and 2.7% developed anti-HBs. Conclusion: The results indicate that HBs Ag does not cross the placental barrier. The infection may occur at the time of birth or be given soon after birth. The infants of HBV Positive mothers must be vaccinated soon after birth and HBIG immediately within 24 hours of birth.

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