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HbSAg+ & HBeAg+ -- Pregnancy (Asian American)
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HbSAg+ & HBeAg+ -- Pregnancy (Asian American)

For the last decade or more, hbv infection is supposedly prevented 95% of the time if the infant is given HBIG and a first dose of the vaccine within 12 hours of birth, and 2 more at the recommended intervals through the first 12 months.

10 years ago, prenatal bloodwork discovered the condition that the mother was HbSAg+ and HbEAg+. I promptly got tested, and to my surprise I had neither the surface antigen nor the antibody. So I got vaccinated with three doses, and I haven't looked back.

Anyways, my child was born, and promptly received the prescribed regimen of HBIG and vaccine. At 95% effectiveness, I put faith in these statistics, and assumed everything is okay.

BUT...
I am finding a couple studies nowadays (2009-2010) on Google that are experimenting with administering antivirals and/or HBIG to the mother BEFORE birth, because they are now suspecting that the virus can cross the placenta during pregnancy especially in HBeAg+ mothers. So if I read on, the conclusion is that, with HBeAg+ mothers with increasing viral DNA, then the HBIG + vaccine at birth is now only 79% effective (as compared with an overall 95% effectivness)

I am a nervous wreck right now! Ten years later, I want to get my child tested. I feel like i'd rather live with the uncertainty, than to remove all doubt. It hurts to look into their unsuspecting eyes each day with uncertainty.

Can someone chime in on this topic?
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Avatar_m_tn

administering antivirals and/or HBIG to the mother BEFORE birth

it is not experiment, it is usual practice when hbe pos and hbvdna elevated since now we know that that 95% can be made 100% by antivirals

just make a simple protective antibody test, hbsab, it is usually ready same day or following day, if antibody is <10miu/ml you need remake vaccine.
at the same time i'd check also hbsag antigen, it must be negative

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Avatar_m_tn
10 years ago, prenatal bloodwork discovered the condition that the mother was HbSAg+ and HbEAg+. I promptly got tested, and to my surprise I had neither the surface antigen nor the antibody.

--If you were the father, then it must be that you had HBsAB that was not shown positive.  Relatively speaking, a father's HBsAg is harded to be passed on to the offsprings.  Have all your children tested as stefano170669 advised.  It is not worth being a nervous wreck.  The children's health is better protected by knowing the truth.
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Avatar_m_tn
Have all your children tested as stefano170669 advised.  It is not worth being a nervous wreck.  The children's health is better protected by knowing the truth.

--- Yup, I think I have to do it now. As with his mother a decade ago, there is less stress to maintain and screen than the initial shock of discovery. It's just there isn't much I can do about it now anyways, nor in the next 10 years.
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Avatar_m_tn
[it is not experiment, it is usual practice when hbe pos and hbvdna elevated since now we know that that 95% can be made 100% by antivirals]

Thanks for the quick reply. Correct me if i'm wrong, but I see from your profile that you work in this field.
When did it become standard practice to give antivirals (e.g. Viread) for hbvdna positive mothers? 10 years ago, I believe lamiviudine and interferon were the only approved anti-hbv treatments. Hepsera, Viread for hbv, entecavir, etc. have only been approved the past 5 years. I was never given this advice 10 years ago. Either the obstretician was totally ignorant or she was just following the normal protocol during her time.

Is the increased risk of infection by mothers with hbvdna due to virus crossing the placenta of the fetus? Or is the risk naturally higher because there is more virus exposure at childbirth?

I have also read that the placenta is a good barrier to prevent the virus from crossing. Whether or not such data is now refuted with more research, it alarms me that hbvdna may cross the placenta!

There are so many evolving and changing conclusions lately. Back then, Hbeag was a good indicator of infectivity to babies and others. Now, it seems that DNA levels are what to worry about.

One more thing --- Is it true that HBVDNA crosses the placenta, it merely cripples the infant's immune system to produce antibodies to the surface antigen? Thus the infant is momentarily virus-free at the moment of childbirth, but the vaccine won't help much.?

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