Immunization interventions to interrupt hepatitis B virus mother-to-child transmission: a meta-analysis of randomized controlled trials

BMC Pediatrics

Pei Liu³  Bei Wang³  Yaoyun Zhao²  Xuefeng Zhang¹  Zhaoying Tan¹  Yueyuan Zhao²  Hui Jin³ 

[1] Jiangsu Provincial Centre for Disease Control and Prevention, Nanjing, China;Department of Epidemiology and Health Statistics, Southeast University, Nanjing, China;Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China

关键词: Mother-to-child transmission;    Meta-analysis;    Hepatitis B virus;    Hepatitis B immunoglobulin;   

Others  :  1090376
DOI  :  10.1186/s12887-014-0307-2

 received in 2014-09-18, accepted in 2014-12-07,  发布年份 2014

【 摘 要 】

Background

This study aimed to determine the clinical efficacy of various immune interventions on mother-to-child transmission (MTCT) of hepatitis B virus (HBV).

Methods

We retrieved different immune strategies on how to prevent MTCT reported in the literature from Chinese and English electronic databases from the viewpoint of intrauterine and extrauterine prevention. Relative risk (RR) and 95% confidence interval (CI) methods were used.

Results

Twenty-five articles on intrauterine prevention and 16 on extrauterine prevention were included in the analysis. Intrauterine prevention could reduce infants’ HBV infection rate (RR = 0.36, 95% CI: 0.28-0.45) and increase their anti-hepatitis B surface–positive rate (RR = 2.42, 95% CI: 1.46-4.01) at birth. Compared with passive immunization, passive-active immunization could reduce infants’ HBV infection rate (RR = 0.66, 95% CI: 0.52-0.84) at birth, even at more than 12 months of age (RR = 0.54, 95% CI: 0.42-0.69). Subgroup analysis demonstrated similar results except for pregnant women who were hepatitis B surface antigen–positive. Funnel plots and Egger’s tests showed publication bias mainly in intrauterine prevention not in extrauterine one.

Conclusions

The long-term protective effect of pregnant women injected with hepatitis B immunoglobulin during pregnancy should be further validated by large-scale randomized trials. Newborns of pregnant women who carried HBV should undergo a passive-active immunization strategy.

【 授权许可】

   
2014 Jin et al.; licensee BioMed Central.

【 图 表 】

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