Hepatitis B Clinical Trial
Official title:
A Fetal Seroepidemiologic Study in Hepatitis B Virus Transmitted Via Male Germ Line
Animal experiments demonstrated that father might transmit HBV vertically via male germ line, however, whether it is really existed in human remains to be determined. Since HBV is a blood-borne virus, the unvaccinated pregnant women would be at risk for HBV exposure if their fetuses carried the virus from fathers. If women had been vaccinated for HBV before conception, what would happen to a maternal immune system if her fetus carried HBV from spermatozoa? However, the literature on transmission of HBV by spermatozoa in vivo is rare, the viral replicating status and fetal immune response in uterus are unknown. The aim of study was to detect father-to-fetus transmission of hepatitis B virus (HBV) in uterus.
Transmission of hepatitis B virus (HBV) from mother-to-infant is the predominant route in
most high prevalence areas such as China. However, father-to-child transmission also plays
another important role in the prevalence of hepatitis B. Children infected with HBV from
their carrier fathers would be horizontally by postnatal intimate contact or vertically via
male germ line. The latter is considered an intrauterine infection, however, whether it is
really existed in human remains to be determined.
In past decades, several experiments reported there presences of integrated HBV DNA in human
spermatozoal chromosomes. Studies on embryos hybridized with mammalian ova and human
spermatozoa were also confirmed that sperm-integrated HBV DNA can replicate and express the
HBV protein in two-cell' hybrid embryos. All above findings demonstrated that father might
transmit HBV to fetus by spermatozoa in theory.
Since HBV is a blood-borne virus, the unvaccinated pregnant women would be at risk for HBV
exposure if their fetuses carried the virus from fathers. On other hand, maternal antibodies
can pass through the placenta and enter the fetal circulation freely. If women had been
vaccinated for HBV before conception, thus some attractive questions are raised that what
would happen to a maternal immune system if her fetus carried HBV from spermatozoa? Would
the fetus be passive immunized by hepatitis B immunoglobulin leaked from maternal
circulation? However, the literature on transmission of HBV by spermatozoa in vivo is rare,
the viral replicating status and fetal immune response in uterus are unknown. Only one study
had detected HBV DNA and serological makers on eight aborted fetuses suspected with HBV
transmission via spermatozoa, but it is a small sample study and the maternal serological
status is uncertain.
Specimens applied for evaluating intrauterine infection include amniotic fluids, placental
tissue and neonatal peripheral blood. Because postnatal sample is inevitably to be
contaminated by maternal blood during delivery, it would be useless to determine the time
when the infection was occurred (before or during the partum). A better alternative is
detecting fetal infection before the partum by prenatal diagnostic technique. Comparing to
the postnatal specimens, intrauterine specimens obtained from amniocentesis or cordocentesis
can minimize the contamination of maternal blood. It is also a safety technique and the risk
of nosocomial infection caused by invasive procedures is very low. The aim of this study was
to investigate the fetal hepatitis B seroepidemiology by prenatal diagnostic technique and
to find the evidence of HBV vertical transmission via spermatozoa.
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Observational Model: Case Control, Time Perspective: Prospective
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