Breast-Feeding is Not a Risk Factor of Mother-to-Child Transmission of Hepatitis B Virus

Figures & data

Table 1 Level of HBV-DNA in Milk of Pregnant Women with Different Viral Load in Serum

Groups	N	HBV Seroprevalence n (%)	Level of HBV-DNA in Colostrum, n (%)				Level of HBV-DNA in Mature Milk, n (%)
			<5×10^2	5×10^2 ~ 1×10^4	>1×10^4~5	Positive	<5×10^2	5×10^2~1×10^4	>1×10^4~5	Positive
HBV-	104	0 (0.0)	104 (100.0)	0 (0.0)	0 (0.0)	0 (0.0)^a	104 (100.0)	0 (0.0)	0 (0.0)	0 (0.0)^d
LVL	83	83 (100.0)^g	78 (94.0)	5 (6.0)	0 (0.0)	5 (6.0)^b	67 (100.0)	0 (0.0)	0 (0.0)	0 (0.0)^e
HVL	98	98 (100.0)^h	21 (21.4)	57 (58.2)	20 (20.4)	77 (78.6)^c	55 (84.6)	10 (15.4)	0 (0.0)	10 (15.4)^f

Notes: Comparison between HBV-, LVL and HVL group about the positive rate of HBV-DNA in colostrum: ^{a vs b}P = 0.011; ^{a vs c}P < 0.001; ^{b vs c}P < 0.001. Comparison between HBV-, LVL and HVL group about the positive rate of HBV-DNA in mature milk: ^{d vs f}P < 0.001; ^{e vs f}P < 0.001. Positive rate of HBV-DNA between serum and colostrum in LVL group: ^{g vs b}P < 0.001; Positive rate of HBV-DNA between serum and colostrum in HVL group: ^{h vs c}P < 0.001; Positive rate of HBV-DNA between serum and mature milk in HVL group: ^{h vs f}P < 0.001. Positive rate of HBV-DNA between colostrum and mature milk in HVL group: ^{c vs f}P>0.05.

Abbreviations: HBV-, HBV-DNA negative group; LVL, low viral load group; HVL, high viral load group.

Table 2 Characteristics of Pregnant Women and Infants Between Groups

Groups	N	Normal ALT During Pregnancy n (%)	Caesarean Section N (%)	Gestational Weeks at Delivery (Mean ± SD, Weeks)	NBW (Mean ± SD, g)	HBeAg + at Birth n (%)	HBV-DNA at Birth n (%)
	HBV- group
Breast-feeding	80	75 (94.9)	57 (71.3)	39.3±1.0	3406.3±417.8	3 (3.8)	0 (0.0)
Formula-feeding	79	71 (89.9)	48 (60.8)	39.7±1.0	3481.0±434.6	3 (3.8)	0 (0.0)
χ2 or t value		1.443	1.95	−2.66	−1.11	—*	—
P value		0.23	0.163	0.009	0.27	1	—
	LVL group
Breast-feeding	69	59 (85.5)	29 (42.0)	39.5±1.0	3402.2±400.2	18 (26.1)	0 (0.0)
Formula-feeding	60	52 (86.7)	44 (73.3)	39.3±1.1	3361.7±406.8	18 (30.0)	0 (0.0)
χ2 or t value		0.036	12.802	1.08	0.57	0.244	—
P value		0.85	0.0003	0.282	0.57	0.621	—
	HVL group
Breast-feeding	65	56 (86.2)	31 (47.7)	39.5±1.1	3376.2±410.7	62 (95.4)	6 (9.2)
Formula-feeding	84	75 (90.4)	49 (58.3)	39.6±1.2	3353.6±404.3	79 (94.1)	6 (7.1)
χ2 or t value		0.635	1.669	−0.42	0.34	0.129	0.216
P value		0.426	0.196	0.673	0.738	0.72	0.642

Notes: “—”no value; *Fisher exact test.

Abbreviations: HBeAg, hepatitis B e antigen; ALT, alanine transaminase.

Table 3 HBV Infection and Immune Response of Infants

	Baby at 1 Month			Baby at 7 Months			Baby at 1~2-Year Old
	N	HBsAb + N (%)	HBsAb [M (P25~P75), IU/L]	N	HBsAb + N (%)	HBsAb [M (P25~P75), IU/L]	N	HBV Infection of Infants N (%)
	HBV- group
Breast-feeding	79	79 (100)	134.0 (114.7~155.9)	60	59 (98.3)	830.1 (327.8~1000.0)	57	1 (1.8)
Formula-feeding	73	72 (98.6)	120.2 (98.6~136.1)	62	62 (100)	869.8 (374.4~1000.0)	59	2 (3.4)
χ2 or t value		—*	−2.965		—*	−0.027		—*
P value		0.48	0.003		0.492	0.979		1.000
	LVL group
Breast-feeding	68	67 (98.5)	117.0 (97.9~131.5)	54	53 (98.2)	666.8 (193.6~1000.0)	52	0 (0.0)
Formula-feeding	53	53 (100.0)	107.6 (97.31~134.8)	55	54 (98.2)	457.6 (269.9~992.0)	44	0 (0.0)
χ2 or t value		—*	0.619		—*	1.145		—
P value		1	0.536		1	0.252		—
	HVL group
Breast-feeding	63	58 (92.1)	120.6 (95.1~140.7)	44	42 (95.5)	218.7 (65.3~861.1)	54	6 (11.1)
Formula-feeding	79	77 (97.5)	122.3 (102.6~144.6)	57	53 (93.0)	514.1 (105.0~1000.0)	45	1 (2.2)
χ2 or t value		2.185	−1.166		—*	−1.545		2.952
P value		0.139	0.244		0.694	0.122		0.086

Notes: “—”no value; *Fisher exact test.

Abbreviation: HBsAb, hepatitis B surface antibody.

Table 4 Logistic Regression Analysis of Risk Factors of HBV Infection in Infants

Variables	Groups	RR (95% CI)	P value
Method of feeding	Breast-feeding	1.004 (0.268,3.763)	0.996
	Formula-feeding	ref
HBsAg of colostrum	Positive	1.662 (0.253,10.901)	0.597
	Negative	ref
HBV-DNA load in serum of pregnant women	Positive	2.881 (0.388,21.415)	0.301
	Negative	ref