Background Evaluation of the impact on mother-to-child transmission (MTCT) of a HBV-prevention program that incorporates maternal antiviral prophylaxis is hindered by the limited availability of real-world data. Methods This study analyzed data on maternal HBV screening, neonatal immunization, and post-vaccination serologic testing (PVST) for HBsAg among at-risk infants born to HBV carrier mothers from the National Immunization Information System during 01/01/2008–31/12/2022. Through linkage with the National Health Insurance Database, information of maternal antiviral therapy was obtained. Multivariate logistic regression was performed to explore MTCT risk in relation to infant-mother characteristics and prevention strategies. Results Totally, 2,460,218 deliveries with maternal HBV status were screened. Between 2008 and 2022, the annual HBsAg and HBeAg seropositivity rates among native pregnant women aged 15–49 years decreased from 12.2% to 2.6% and from 2.7% to 0.4%, respectively (p for both trends < 0.0001). Among the 22,859 at-risk infants undergoing PVST, the MTCT rates differed between infants born to HBsAg-positive/HBeAg-negative and HBeAg-positive mothers (0.75% and 6.33%, respectively; p < 0.001). The MTCT rate was 1.72% (11/641) for infants born to HBeAg-positive mothers with antiviral prophylaxis. MTCT risk increased with maternal HBeAg-positivity (OR 9.29, 6.79–12.73) and decreased with maternal antiviral prophylaxis (OR 0.28, 0.16–0.49). For infants with maternal HBeAg-positivity, MTCT risk was associated with mothers born in the immunization era (OR 1.40, 1.17–1.67). Conclusions MTCT was related to maternal HBeAg-positivity and effectively prevented by maternal prophylaxis in the immunized population. At-risk infants born to maternal vaccinated cohorts might possibly pose further risk.

中文翻译：

---

优化母婴乙型肝炎病毒预防方案：母婴筛查与婴儿疫苗接种后血清学检测相结合

背景 现实世界数据有限，阻碍了对纳入孕产妇抗病毒预防的乙型肝炎预防计划对母婴传播 (MTCT) 影响的评估。方法 本研究分析了 2008 年 1 月 1 日至 2008 年 1 月 31 日国家免疫信息系统中乙肝病毒携带者母亲所生高危婴儿的母亲 HBV 筛查、新生儿免疫和疫苗接种后 HBsAg 血清学检测 (PVST) 数据。 /2022。通过与国家医保数据库联动，获取孕产妇抗病毒治疗信息。采用多变量逻辑回归来探讨母婴传播风险与母婴特征和预防策略的关系。结果 总共筛查了 2,460,218 名孕产妇 HBV 状况的分娩者。 2008年至2022年间，15-49岁本土孕妇的年度HBsAg和HBeAg血清阳性率分别从12.2%下降至2.6%和2.7%下降至0.4%（两种趋势的p均<0.0001）。在 22,859 名接受 PVST 的高危婴儿中，HBsAg 阳性/HBeAg 阴性和 HBeAg 阳性母亲所生婴儿的 MTCT 率有所不同（分别为 0.75% 和 6.33%；p < 0.001）。 HBeAg 阳性且接受抗病毒预防的母亲所生婴儿的 MTCT 率为 1.72% (11/641)。母婴传播风险随母亲 HBeAg 阳性而增加（OR 9.29、6.79-12.73），随母亲抗病毒预防而降低（OR 0.28、0.16-0.49）。对于母亲 HBeAg 阳性的婴儿，母婴传播风险与出生在免疫时代的母亲相关（OR 1.40，1.17-1.67）。结论 母婴传播与母亲 HBeAg 阳性有关，在免疫人群中通过母亲预防可以有效预防母婴传播。母亲接种疫苗的群体所生的高危婴儿可能会带来进一步的风险。