https://www.ncbi.nlm.nih.gov/pubmed/29473269

Hepatitis B
Hepatol Res. 2018 Feb 23. doi: 10.1111/hepr.13072. [Epub ahead of print]
Chen HL, Zha ML, Cai JY, Qin G.

Abstract

OBJECTIVES:
The aim of this study was to assess the relationship between maternal viral load and mother-to-childtransmission (MTCT) risk in 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 negative group. We also examined the dose-response effect of this relationship.

RESULTS:
21 studies with 10,142 mother-child pairs included in the studies. The mean MTCT incidence was 13.1% in maternal HBV DNA positive group, compared with 4.2% in negative group. The summary MTCT odds ratio (OR) of maternal HBV DNA positive compared with negative was 9.895 (95% 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, >8 log10 copies/ml level stratifications, the pooled MTCT incidences were 2.754% (95% CI 1.198% to 4.310%; Z=3.47, P=0.001), 9.932% (95% CI 6.349% to 13.516%; Z=5.43, P<0.00001), and 14.445% (95% CI 8.317% to 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 nonlinear 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.