Fax +41 61 306 12 34 E-Mail karger@karger.ch www.karger.com Short Communication Intervirology 2009;52:132–134 DOI: 10.1159/000219852 Clinical Significance of Hepatitis B Surface Antigen in Cord Blood of Hepatitis B e-Antigen-Negative Chronic Hepatitis B Virus-Infected Mothers I.S. Elefsiniotis a, b M. Papadakis a G. Vlahos a G. Daskalakis a G. Saroglou b A. Antsaklis a a First Department of Obstetrics and Gynecology, University of Athens, ‘Alexandra’ Hospital, and b Department of Internal Medicine-Hepatology and Infectious Diseases Unit, ‘Elena Venizelou’ Hospital, University of Athens, Athens, Greece Vertical transmission of hepatitis B virus (HBV) infec- tion during the perinatal period is the major cause of HBV transmission in endemic countries [1]. In countries with high HBV prevalence, intrauterine/transplacental transmission is observed in a significant proportion of pregnancies, resulting in passive-active immunoprophy- laxis failure and dissemination of the HBV infection [2, 3]. In Greece, the overall seroprevalence of HBsAg posi- tivity among women of reproductive age is relatively low, but is higher among immigrants who live and work in our country [4]. The vast majority of HBsAg-positive women in our country ( 195%) are HBeAg negative [5]. Despite that, about a third of them exhibit high or even extreme- ly high viral load during the perinatal period [5] , mainly due to a precore mutation (G1896A) of the HBV genome. Data concerning the serological and virological profiles of cord blood, as well as of the placental pathology for HBV antigens, from HBeAg-negative chronic HBV-in- fected women in Europe are limited. The aim of our study was to evaluate the serological and virological profiles of HBV infection in cord blood samples obtained from HBeAg-negative chronic HBV-in- fected women at delivery, and to investigate their relation- ship with the clinical outcome (possible transmission of HBV) in neonates receiving the currently approved pas- sive-active immunoprophylaxis schedule. Key Words Hepatitis B surface antigen  Cord blood  Hepatitis B virus  Vertical transmission Abstract Vertical transmission of hepatitis B virus (HBV) infection dur- ing the perinatal period is the major cause of HBV transmis- sion. The aim of our study was to evaluate the serological and virological profiles of HBV infection in cord blood sam- ples obtained from HBeAg-negative chronic HBV-infected women, at delivery, and to investigate their relationship with the clinical outcome (possible transmission of HBV) in neo- nates receiving the currently approved passive-active im- munoprophylaxis schedule. Sixteen women (32%) exhibited HBsAg positivity in the cord blood but HBV-DNA has not been detected in any of the 50 cord blood samples evalu- ated. We conclude that HBsAg can be transferred through the placental barrier, as with other proteins, in about one third of HBeAg-negative chronic HBV-infected pregnant women, irrespective of the maternal viral load, the mode of delivery or the placenta HBV pathology. The clinical impact of this phenomenon on the intrauterine-transplacental or perinatal transmission of HBV infection and/or passive-ac- tive immunoprophylaxis failure does not seem to be impor- tant. Copyright © 2009 S. Karger AG, Basel Received: February 17, 2009 Accepted after revision: March 30, 2009 Published online: May 25, 2009 Ioannis S. Elefsiniotis, MD Carchidonos 9 GR–16562 A. Glyfada (Greece) E-Mail ielefs@nurs.uoa.gr © 2009 S. Karger AG, Basel 0300–5526/09/0523–0132$26.00/0 Accessible online at: www.karger.com/int