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Background <p>Hepatitis B virus (HBV) infection is a major global health concern. Serological patterns such as “HBeAb + and HBcAb+” or “HBcAb + only” are typically markers, which may represent either resolved infection or potential occult HBV infection (OBI) with risk of vertical transmission. But OBI in these subgroups of pregnant women in Northwest China remains underreported. This study evaluates OBI prevalence in HBcAb-positive, HBsAb-negative, and HBsAg-negative pregnant women in northwest China and analyzes HBV infection trends from 2015 to 2022.</p> Methods <p>This study included 524,319 pregnant women who underwent antenatal screening at Northwest Women and Children’s Hospital from January 2015 to December 2022. Epidemiological characteristics of HBV infection were analyzed by year and age. Additionally, 168 serum samples from women with positive “HBeAb + and HBcAb+” or “HBcAb + only” results (collected between October 2022 and July 2023) were tested for HBV nucleic acids (RNA and DNA) to assess OBI prevalence.</p> Results <p>From 2015 to 2022, the prevalence of Active HBV infection (HBsAg-positive cases) in pregnant women was 3.29%, with 17.99% having a history of HBV infection or OBI, 31.07% susceptible, and 47.65% immune through vaccination. Active infection showed a linear decrease from 3.80% in 2016 to 2.82% in 2022 (<i>p</i> &lt; 0.001), while history of HBV infection or OBI declined from 22.33 to 16.06% (<i>p</i> &lt; 0.001). Vaccine-induced immunity increased from 43.67 to 49.30% (<i>p</i> &lt; 0.001). Age-wise, older age groups exhibited a higher prevalence of Active HBV infection (HBsAg-positive cases), likely reflecting cumulative exposure. (<i>p</i> &lt; 0.001). Susceptibility decreased with age, from 39.93% in the 18–25 group to 28.40% in the 36–45 group (28.88% reduction). Vaccine-induced immunity also declined from 49.98% in the 26–30 group to 40.15% in the 36–45 group (19.67% reduction). Among pregnant women with positive “HBeAb + and HBcAb+” or “HBcAb + only” results, OBI prevalence was 0%, compared to 6% in those with HBV seronegative negative results.</p> Conclusion <p>In our study, no OBI was detected in this specific subgroup (“HBeAb + and HBcAb+” or “HBcAb + only”), suggesting a low likelihood in this population. However, further studies with larger cohorts and diverse detection methods are needed to confirm this finding. Despite a decline in HBsAg positivity, HBV remains moderately prevalent, the persistently high HBV susceptibility rate (31.07%) underscores an urgent need for targeted vaccination efforts among women of childbearing age in Northwest China.</p>

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Analysis of HBV infection characteristics and OBI prevalence in pregnant women: a focus on HBcAb + alone or in combination with HBeAb + subgroups in Northwest China

  • 期刊论文

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  • 发表日期：

    2025年8月18日

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  • Yun Xie,
  • Ru Kang,
  • Xiaoyue Cheng,
  • Dan Li,
  • Qi Wang,
  • Jiao Li,
  • Xuan Guo,
  • Wenhui Gao,
  • Xin He,
  • Liutong Jiang,
  • Gaili Meng

摘要

Background

Hepatitis B virus (HBV) infection is a major global health concern. Serological patterns such as “HBeAb + and HBcAb+” or “HBcAb + only” are typically markers, which may represent either resolved infection or potential occult HBV infection (OBI) with risk of vertical transmission. But OBI in these subgroups of pregnant women in Northwest China remains underreported. This study evaluates OBI prevalence in HBcAb-positive, HBsAb-negative, and HBsAg-negative pregnant women in northwest China and analyzes HBV infection trends from 2015 to 2022.

Methods

This study included 524,319 pregnant women who underwent antenatal screening at Northwest Women and Children’s Hospital from January 2015 to December 2022. Epidemiological characteristics of HBV infection were analyzed by year and age. Additionally, 168 serum samples from women with positive “HBeAb + and HBcAb+” or “HBcAb + only” results (collected between October 2022 and July 2023) were tested for HBV nucleic acids (RNA and DNA) to assess OBI prevalence.

Results

From 2015 to 2022, the prevalence of Active HBV infection (HBsAg-positive cases) in pregnant women was 3.29%, with 17.99% having a history of HBV infection or OBI, 31.07% susceptible, and 47.65% immune through vaccination. Active infection showed a linear decrease from 3.80% in 2016 to 2.82% in 2022 (p < 0.001), while history of HBV infection or OBI declined from 22.33 to 16.06% (p < 0.001). Vaccine-induced immunity increased from 43.67 to 49.30% (p < 0.001). Age-wise, older age groups exhibited a higher prevalence of Active HBV infection (HBsAg-positive cases), likely reflecting cumulative exposure. (p < 0.001). Susceptibility decreased with age, from 39.93% in the 18–25 group to 28.40% in the 36–45 group (28.88% reduction). Vaccine-induced immunity also declined from 49.98% in the 26–30 group to 40.15% in the 36–45 group (19.67% reduction). Among pregnant women with positive “HBeAb + and HBcAb+” or “HBcAb + only” results, OBI prevalence was 0%, compared to 6% in those with HBV seronegative negative results.

Conclusion

In our study, no OBI was detected in this specific subgroup (“HBeAb + and HBcAb+” or “HBcAb + only”), suggesting a low likelihood in this population. However, further studies with larger cohorts and diverse detection methods are needed to confirm this finding. Despite a decline in HBsAg positivity, HBV remains moderately prevalent, the persistently high HBV susceptibility rate (31.07%) underscores an urgent need for targeted vaccination efforts among women of childbearing age in Northwest China.