A341 ANALYSIS OF SERUM HEPATITIS B VIRUS RNA LEVELS IN A MULTIETHNIC COHORT OF PREGNANT CHRONIC HEPATITIS B CARRIERS. (1st March 2018) - Patel, N H
Abstract: Background: Mother to child transmission (MTCT) of HBV is one of the most common routes of transmission worldwide. All infants born to HBV+ mothers should receive complete immunoprophylaxis with HBV immune globulin (HBIG) and vaccine. In some mothers with high HBV DNA levels (>2x 10 5 IU/mL), antiviral therapy is recommended to further reduce MTCT risk. We had previously documented HBV immune (cytokine) and alanine aminotransferase (ALT) flares in pregnancy; as well as, HBV DNA correlation with quantitative (q) HBV surface antigen levels 1, 2, 3, 4 . There are no prior studies quantitavely assessing other HBV replication markers (i.e., HBV RNA and pre-genomic RNA levels) in pregnancy. Aims: To analyze HBV RNA levels in association with HBV DNA, qHBsAg, genotype and ALT levels in pregnant and/or post-partum Chronic Hepatitis B (CHB) carriers. Methods: In total, sera and plasma from 38 CHB pregnant and/or post-partum women were tested for HBV DNA, including 34/38 for qHBsAg levels by standard clinical assays (Abbott Architect). Serum HBV RNA levels was assessed by in-house qPCR using HBV X gene specific primers (based on a plasmid dilution standard curve). The HBV genotype was determined in (31/38, 82%) by commercial line probe assay (LiPa) or in-house nested PCR using HBV S gene specific primers and Sanger sequencing, according to previously published protocols. Data was analyzed using indepdendent and paired t-test where p<0.05 was considered significant. Results: In 38 pregnant CHB carriers (median age 32 y, 53% Asian, 32% African, 15% other), were 79% (30/38) HBeAg negative, and 21% (8/38) on antiviral therapy with Tenofovir Disoproxil Fumarate. In 31/38 patients with HBV genotype results, showed 13% A, 36%B, 19%C, 19%D and13%E. The median ALT, HBV DNA and qHBsAg levels were 19.5 U/L; 2.85 log10 IU/mL and 3.3 log10 IU/mL, respectively. Analysis of serum RNA levels showed undetectable HBV RNA in 21% (8/38), detectable but not quantifiable in 32% (12/38), and quantifiable levels in 47% (18/38) tested. In 6 matched pregnant vs. post-partum samples, the serum HBV RNA decreased from a median of 3.47 to 3.01 log10 IU/mL. There was no significant association between HBV RNA levels and HBV DNA levels, qHBsAg, genotype or ALT levels tested. Conclusions: In this multiethnic cohort of CHB carriers in pregnancy, serum HBV RNA levels are not associated with HBV DNA, qHBsAg, genotype or ALT levels. Further studies involving assessment of other HBV virological and serological markers (i.e., HBV pre-genomic RNA, quantitative HBV core antigen) may help increase understanding of HBV natural history in pregnancy. References: 1. Joshi et al; AJRI; 2017. 2. Kochaksaraei et al; JVH; 2016. 3. Kochaksaraei et al; Liver Int; 2016. 4. Virine et al; PLos One; 2015. Funding Agencies: None