Comparative Effectiveness of Prophylactic Strategies for Perinatal Transmission of Hepatitis B Virus: A Network Meta-analysis of Randomized Controlled Trials Article Swipe
Zhixian Chen
,
Xun Zhuang
,
Xiaohong Zhu
,
Yanli Hao
,
Gui-Fang Gu
,
Mengzhi Cai
,
Gang Qin
·
YOU?
·
· 2017
· Open Access
·
· DOI: https://doi.org/10.1093/ofid/ofx225
YOU?
·
· 2017
· Open Access
·
· DOI: https://doi.org/10.1093/ofid/ofx225
Background Perinatal transmission is the main route of hepatitis B virus (HBV) transmission. While several measures have been attempted as means of preventing perinatal HBV transmission, the optimal strategy remains inconclusive. Methods We conducted a comprehensive search, through December 2016, for randomized controlled trials (RCTs) that compared the following measures among pregnant women with HBV infection: placebo/none, active immunoprophylaxis (hepatitis B vaccine series starting at birth [HBVac]), passive-active immunoprophylaxis (hepatitis B immunoglobulin and vaccine [HBIG+HBVac]), prenatal HBIG administration (HBIG/HBIG+HBVac), and prenatal antiviral therapy (AVT/HBIG+HBVac). Direct, indirect, and network meta-analyses were performed for all treatment comparisons. Results Fifteen RCTs involving 2706 infants of HBV carrier mothers were eligible for analysis. Network meta-analysis demonstrated similar results as direct and indirect comparisons. HBVac alone significantly reduced the risk of hepatitis B infection in infants of HBV carrier mothers (relative risk [RR], 0.32; 95% confidence interval [CI], 0.21–0.50). The combination of immunoglobulin with vaccine is superior to vaccine alone (RR, 0.37; 95% CI, 0.20–0.67). Prenatal HBIG administration and antiviral therapy offer further advantages over current passive-active immunoprophylaxis for infants of highly viremic (HBV DNA level higher than 2 × 105 IU/mL) mothers (RR, 0.47; 95% CI, 0.29–0.75; and RR, 0.31; 95% CI, 0.10–0.99, respectively). There was no significant publication bias. Conclusions Based on the universal infantile vaccination program, HBIG for infants born to HBV carrier mothers further reduces transmission. For highly viremic mothers whose children are still at risk for transmission under current immunoprophylaxis, prenatal HBIG administration or antiviral therapy in late pregnancy may be considered if more long-term evidence supports its efficacy and safety.
Related Topics
Concepts
Medicine
Meta-analysis
Hepatitis B virus
Randomized controlled trial
Transmission (telecommunications)
Hepatitis B vaccine
Relative risk
Hepatitis B
Vaccination
Pediatrics
Pregnancy
Confidence interval
Virology
Immunology
Internal medicine
Virus
Engineering
HBsAg
Biology
Electrical engineering
Genetics
Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1093/ofid/ofx225
- https://academic.oup.com/ofid/article-pdf/4/4/ofx225/21861383/ofx225.pdf
- OA Status
- gold
- Cited By
- 11
- References
- 48
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W2765283007
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
-
https://openalex.org/W2765283007Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1093/ofid/ofx225Digital Object Identifier
- Title
-
Comparative Effectiveness of Prophylactic Strategies for Perinatal Transmission of Hepatitis B Virus: A Network Meta-analysis of Randomized Controlled TrialsWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2017Year of publication
- Publication date
-
2017-01-01Full publication date if available
- Authors
-
Zhixian Chen, Xun Zhuang, Xiaohong Zhu, Yanli Hao, Gui-Fang Gu, Mengzhi Cai, Gang QinList of authors in order
- Landing page
-
https://doi.org/10.1093/ofid/ofx225Publisher landing page
- PDF URL
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https://academic.oup.com/ofid/article-pdf/4/4/ofx225/21861383/ofx225.pdfDirect link to full text PDF
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YesWhether a free full text is available
- OA status
-
goldOpen access status per OpenAlex
- OA URL
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https://academic.oup.com/ofid/article-pdf/4/4/ofx225/21861383/ofx225.pdfDirect OA link when available
- Concepts
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Medicine, Meta-analysis, Hepatitis B virus, Randomized controlled trial, Transmission (telecommunications), Hepatitis B vaccine, Relative risk, Hepatitis B, Vaccination, Pediatrics, Pregnancy, Confidence interval, Virology, Immunology, Internal medicine, Virus, Engineering, HBsAg, Biology, Electrical engineering, GeneticsTop concepts (fields/topics) attached by OpenAlex
- Cited by
-
11Total citation count in OpenAlex
- Citations by year (recent)
-
2024: 3, 2023: 2, 2022: 2, 2021: 1, 2020: 1Per-year citation counts (last 5 years)
- References (count)
-
48Number of works referenced by this work
- Related works (count)
-
10Other works algorithmically related by OpenAlex
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