| ObjectivesTo evaluate the effectiveness of mother-to-child blockade of hepatitis B in infants born to hepatitis B surface antigen(HBsAg)-positive mothers in Yunnan Province at different times,to understand the seroprevalence of hepatitis B in children born after mother-to-child blockade,to analyse the factors affecting the persistence of hepatitis B vaccine in children,and to understand the regression of HBsAg-positive mothers after delivery,so as to provide a strong scientific basis for the subsequent development and improvement of hepatitis B control strategies in Yunnan Province.MethodsUsing the present study method,HBsAg-positive mothers and their infants born in 2009-2010,2014-2015 and 2019-2020 were selected from local delivery facilities in Tonghai,Yulong and Guangnan counties of Yunnan Province in 2022,and all infants born had completed the full course of hepatitis B vaccination(Hep B).Questionnaires were administered and serum specimens were collected after obtaining informed consent from the respondents.The questionnaires mainly contained information on basic demographic information,history of prenatal and post-pregnancy hepatitis B treatment,history of hepatitis B vaccination and hepatitis B immunoglobulin(HBIG)vaccination,etc.The collected specimens were tested for HBsAg,hepatitis B surface antibody(HBs Ab)and hepatitis B e antibody(HBE)by enzyme-linked immunoassay and HBV DNA quantitative fluorescence assay.HBsAg,Hepatitis B surface antibody(HBs Ab),Hepatitis B e antigen(HBe Ag),Hepatitis B e antibody(HBe Ab),Hepatitis B core antibody(HBc Ab)and HBV DNA viral load were measured by enzyme-linked immunoassay and HBV DNA quantification.Epi Data 3.1 software was used to establish the database and to double-enter the data;SPSS 20.0 software was used to conduct statistical analysis of the study indicators,using rates and composition ratios for descriptive analysis,χ~2 test or Fisher’s exact probability method for single-factor analysis;dichotomous logistic regression model was used for multi-factor analysis.Results1.A total of 390 maternal and child pairs meeting the criteria were investigated in the study.390 children had an overall HBsAg positivity rate of 2.05%,HBs Ab positivity rate of 68.72%and HBc Ab positivity rate of 30.51%;the overall blockage success rate was 97.95%,with statistically significant differences in HBs Ab positivity rates among children at different times(χ~2=39.70,P<0.05).2.Among the 364 children immunized with the combination of Hep B and HBIG,the success rate of hepatitis B blockade was 97.80%,which was lower than the result of 100.00%for the unknown use of HBIG,with no statistically significant difference(P>0.05,Fisher’s exact probability method);the success rates of hepatitis B blockade among children in Tonghai,Yulong and Guangnan counties were 98.32%,98.00%and97.66%(χ~2=0.25,P>0.05);260 children were tested within six months of completing full Hep B immunisation and their mother-to-child blockade success rate was 99.23%,and in this survey the blockade rate was 98.08%(P>0.05);3 of the 258 children with successful early mother-to-child blockade had positive HBsAg transitions,with a cumulative positive transition rate of The cumulative positive rate was 1.16%.3.64 of the 390 children had a history of booster immunization against hepatitis B.The HBs Ab positivity rate of children with a history of booster immunization was82.81%,which was higher than the HBs Ab positivity rate of 65.95%in children without a history of booster immunization(χ~2=7.08,P<0.05);the HBs Ab positivity rate of the260 children with a history of PVST testing was 71.92%,which was significantly lower than the PVST after the initial immunization The HBs Ab positivity rate of the 260children with a history of PVST testing was 71.92%,which was significantly lower compared with 86.54%at the time of PVST testing after primary immunisation(χ~2=19.01,P<0.05).Factors influencing HBs Ab positivity after primary immunisation in children on univariate analysis were:time of birth(χ~2=27.62,P<0.001),HBIG vaccination status(χ~2=7.25,P<0.05),and primary immunisation response status(χ~2=8.95,P<0.05);factors that had an effect on multivariate analysis were time of birth(OR=4.66,95%CI:2.36-9.19),with higher rates of HBs Ab positivity in children born in 2019-2020 than in children born in 2014-2015(OR=4.66,95%CI:2.36-9.19).4.313 of the 390 mothers in this survey participated in the serological investigation,of which 36 mothers showed HBsAg negative conversion,with a cumulative negative conversion rate of 11.50%and HBsAg negative conversion rates of 10.00%,13.49%and 10.22%in the 2009-2010,2014-2015 and 2019-2020 groups,respectively(χ~2=0.823,P>0.05).The HBe Ag negative maternal HBsAg negative conversion rate was 14.60%,significantly higher than the HBe Ag positive maternal HBsAg negative conversion rate of 3.45%(χ~2=7.68,P<0.05).Conclusions1.The HBsAg positivity rate among children in this survey was at a low level of2.05%,with no significant difference in HBsAg positivity rates among children in different survey areas and delivery times.2.The success rate of hepatitis B blockade in children was relatively high at97.95%,and there was no significant difference in the blocking rate among different investigated regions and time of delivery;Blockade of mother to child transmission of HBV using a combination of HBV vaccine and HBIG in infants born to HBsAg positive parturients was effective,with high blocking success rates(97.80%);The incidence of HBsAg positive conversion in children with successful mother infant blocking was low at 1.16%.3.The HBs Ab positivity rate among children showed a decreasing trend over time in the three time periods surveyed,while booster immunization for hepatitis B increased the HBs Ab positivity rate among children.4.The predominant serological pattern of infection in HBsAg-positive mothers at delivery was"Xiao Sanyang"and"Da Sanyang";the rate of HBsAg negative conversion among mothers was 11.50%,and HBe Ag-negative mothers were more likely to have HBsAg negative conversion. |
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