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Article: Optimal timing of hepatitis B virus DNA quantification and clinical predictors for higher viral load during pregnancy

TitleOptimal timing of hepatitis B virus DNA quantification and clinical predictors for higher viral load during pregnancy
Authors
Keywordshepatitis B
virus immunization
infectious disease transmission, vertical
pregnancy
viral load
Issue Date2019
PublisherJohn Wiley & Sons Ltd. The Journal's web site is located at http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1600-0412
Citation
Acta Obstetricia et Gynecologica Scandinavica, 2019, v. 98 n. 10, p. 1301-1306 How to Cite?
AbstractIntroduction: Authorities publish recommendations on the hepatitis B virus (HBV) viral load threshold to initiate antiviral treatment but the timing of quantification during pregnancy is not well defined. HBV DNA levels in pregnancy women at 28‐30 weeks predict the risk of immunoprophylaxis failure. This study compared and evaluated the correlation between HBV DNA levels before 22 and 28‐30 weeks’ gestation. Clinical predictive factors for HBV DNA >6, 7 and 8 log10 IU/mL were studied. Material and methods: A retrospective analysis of HBV DNA levels of women <22 and 28‐30 weeks of gestation was carried out in 352 pregnant HBV carriers. HBV DNA was examined using the COBAS TaqMan HBV Monitor Test coupled with the COBAS Ampliprep extraction system (Both Roche Diagnostics, Branchburg, NJ, USA). Results: A strong positive correlation was found between the viral loads of women <22 weeks (mean 16.7 weeks) and 28‐30 weeks of gestation, which was independent of the viral load level and gestational age of quantification (r = 0.942, P < 0.001). Univariate analysis showed that positive hepatitis B e antigen (HBeAg), maternal age <35 years old and body mass index ≤21 kg/m2 were associated with a higher mean viral load at 28‐30 weeks of gestation (P < 0.05). These factors were also associated with a higher chance of viral load >6, 7 and 8 log10 IU/mL at 28‐30 weeks (P < 0.05). In multiple regression analysis, only the viral load of <22 weeks and positive HBeAg remained predictive of a higher mean viral load at 28‐30 weeks of gestation (P < 0.05). The receiver operating characteristic curve showed that the HBV DNA of <22 weeks was an excellent predictor for different viral load cut‐offs at 28‐30 weeks. The area under curve was 0.986, 0.998 and 0.994 for viral load 6, 7 and 8 log10 IU/mL, respectively. Conclusions: HBV DNA quantification should be performed before 22 weeks of gestation. Viral load cut‐offs similar to those at 28 weeks can be used to determine immunoprophylaxis failure at earlier gestation. Maternal positive HBeAg status was associated with a higher chance of viral load >6, 7 or 8 log10 IU/mL.
Persistent Identifierhttp://hdl.handle.net/10722/277773
ISSN
2017 Impact Factor: 2.649
2015 SCImago Journal Rankings: 1.197

 

DC FieldValueLanguage
dc.contributor.authorCheung, KW-
dc.contributor.authorSeto, MTY-
dc.contributor.authorSo, PL-
dc.contributor.authorWong, D-
dc.contributor.authorMak, SLA-
dc.contributor.authorLau, WL-
dc.contributor.authorWang, W-
dc.contributor.authorKan, SYA-
dc.contributor.authorLee, CP-
dc.contributor.authorNg, EHY-
dc.date.accessioned2019-10-04T08:01:04Z-
dc.date.available2019-10-04T08:01:04Z-
dc.date.issued2019-
dc.identifier.citationActa Obstetricia et Gynecologica Scandinavica, 2019, v. 98 n. 10, p. 1301-1306-
dc.identifier.issn0001-6349-
dc.identifier.urihttp://hdl.handle.net/10722/277773-
dc.description.abstractIntroduction: Authorities publish recommendations on the hepatitis B virus (HBV) viral load threshold to initiate antiviral treatment but the timing of quantification during pregnancy is not well defined. HBV DNA levels in pregnancy women at 28‐30 weeks predict the risk of immunoprophylaxis failure. This study compared and evaluated the correlation between HBV DNA levels before 22 and 28‐30 weeks’ gestation. Clinical predictive factors for HBV DNA >6, 7 and 8 log10 IU/mL were studied. Material and methods: A retrospective analysis of HBV DNA levels of women <22 and 28‐30 weeks of gestation was carried out in 352 pregnant HBV carriers. HBV DNA was examined using the COBAS TaqMan HBV Monitor Test coupled with the COBAS Ampliprep extraction system (Both Roche Diagnostics, Branchburg, NJ, USA). Results: A strong positive correlation was found between the viral loads of women <22 weeks (mean 16.7 weeks) and 28‐30 weeks of gestation, which was independent of the viral load level and gestational age of quantification (r = 0.942, P < 0.001). Univariate analysis showed that positive hepatitis B e antigen (HBeAg), maternal age <35 years old and body mass index ≤21 kg/m2 were associated with a higher mean viral load at 28‐30 weeks of gestation (P < 0.05). These factors were also associated with a higher chance of viral load >6, 7 and 8 log10 IU/mL at 28‐30 weeks (P < 0.05). In multiple regression analysis, only the viral load of <22 weeks and positive HBeAg remained predictive of a higher mean viral load at 28‐30 weeks of gestation (P < 0.05). The receiver operating characteristic curve showed that the HBV DNA of <22 weeks was an excellent predictor for different viral load cut‐offs at 28‐30 weeks. The area under curve was 0.986, 0.998 and 0.994 for viral load 6, 7 and 8 log10 IU/mL, respectively. Conclusions: HBV DNA quantification should be performed before 22 weeks of gestation. Viral load cut‐offs similar to those at 28 weeks can be used to determine immunoprophylaxis failure at earlier gestation. Maternal positive HBeAg status was associated with a higher chance of viral load >6, 7 or 8 log10 IU/mL.-
dc.languageeng-
dc.publisherJohn Wiley & Sons Ltd. The Journal's web site is located at http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1600-0412-
dc.relation.ispartofActa Obstetricia et Gynecologica Scandinavica-
dc.subjecthepatitis B-
dc.subjectvirus immunization-
dc.subjectinfectious disease transmission, vertical-
dc.subjectpregnancy-
dc.subjectviral load-
dc.titleOptimal timing of hepatitis B virus DNA quantification and clinical predictors for higher viral load during pregnancy-
dc.typeArticle-
dc.identifier.emailCheung, KW: kawang@HKUCC-COM.hku.hk-
dc.identifier.emailSeto, MTY: mimiseto@HKUCC-COM.hku.hk-
dc.identifier.emailMak, SLA: makasl@HKUCC-COM.hku.hk-
dc.identifier.emailLau, WL: lauwl@hkucc.hku.hk-
dc.identifier.emailWang, W: ericawlw@hku.hk-
dc.identifier.emailKan, SYA: kansya@hkucc.hku.hk-
dc.identifier.emailLee, CP: chinpeng@hkucc.hku.hk-
dc.identifier.emailNg, EHY: nghye@hku.hk-
dc.identifier.authorityLee, CP=rp01862-
dc.identifier.authorityNg, EHY=rp00426-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1111/aogs.13631-
dc.identifier.pmid31021394-
dc.identifier.scopuseid_2-s2.0-85067056501-
dc.identifier.hkuros306746-
dc.identifier.volume98-
dc.identifier.issue10-
dc.identifier.spage1301-
dc.identifier.epage1306-
dc.publisher.placeUnited Kingdom-

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