Maternal viral load and hepatitis B virus mother‐to‐child transmission risk: A systematic review and meta‐analysis |
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| Authors: | Hong‐Lin Chen Man‐Li Zha Ji‐Yu Cai Gang Qin |
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| Affiliation: | 1. School of Nursing, Nantong University, Nantong City, Jiangsu Province, China;2. Center for Liver Diseases, Nantong Third People's Hospital, Nantong City, Jiangsu Province, China |
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| Abstract: | ![]()
Aim The aim of this study was to assess the relationship between maternal viral load and mother‐to‐child transmission (MTCT) risk in hepatitis B envelope antigen (HBeAg)‐positive mothers. Methods PubMed and Web of Science were systematically searched. We compared MTCT incidence between maternal hepatitis B virus (HBV)‐DNA‐positive and HBV‐DNA‐negative groups. We also examined the dose–response effect of this relationship. Results Twenty‐one studies with 10 142 mother–child pairs were included in the studies. The mean MTCT incidence was 13.1% in the maternal HBV‐DNA‐positive group, compared with 4.2% in the negative group. The summary MTCT odds ratio of maternal HBV‐DNA positive compared with negative was 9.895 (95% confidence interval [CI], 5.333 to 18.359; Z = 7.27, P < 0.00001) by random‐effects model. In maternal HBV‐DNA <6 log10 copies/mL, 6–8 log10 copies/mL, and >8 log10 copies/mL level stratifications, the pooled MTCT incidences were 2.754% (95% CI, 1.198–4.310%; Z = 3.47, P = 0.001), 9.932% (95% CI, 6.349–13.516%; Z = 5.43, P < 0.00001), and 14.445% (95% CI, 8.317–20.572%; Z = 4.62, P < 0.00001), respectively. A significant linear dose–response association was found between maternal viral load and MTCT risk, with the points estimate of increased MTCT risk 2.705 (95% CI, 1.808–4.047) at 6 log10 copies/mL compared with reference (3 log10 copies/mL), and 7.316 (95% CI, 3.268–16.378) at 9 log10 copies/mL. A significant non‐linear dose–response association was also found between maternal viral load and HBV MTCT risk (model χ2 = 23.43, P < 0.00001). Conclusion Our meta‐analysis indicated that maternal viral load was an important risk factor for MTCT in HBeAg‐positive mothers, and maternal viral load was dose‐dependent with HBV MTCT incidence. |
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| Keywords: | hepatitis B virus maternal viral load mother‐to‐child transmission risk factor |
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