Impact of HBV replication in peripheral blood mononuclear cell on HBV intrauterine transmission

This study determined the effect of hepatitis B virus （HBV） replication in peripheral blood mononuclear cell （PBMC） from HBsAg-positive mothers on HBV intrauterine transmission. A total of 150 HBsAg- positive mothers and their neonates were recruited in this study. Within 24 h after birth, HBV serological markers, serum HBV DNA, PBMC HBV relaxed circular DNA （rcDNA）, and covalently closed circular DNA （cccDNA） were measured in the HBsAg-positive mothers and their neonates before passive-active immune prophylaxis. The relationship between HBV replication in PBMC and HBV intrauterine transmission was examined through Chi- square test and logistic regression. The rate of HBV intrauterine transmission was 8.00% （12/150） in the 150 neonates born to HBsAg-positive mothers. The positivities of PBMC HBV rcDNA and cceDNA in the HBsAg- positive mothers were 36.67% （55/150） and 10% （15/150）, respectively. Maternal PBMC HBV cccDNA was a risk factor of HBV intrauterine transmission （OR = 6.003, 95% Ch 1.249-28.855）. Maternal serum HBeAg was a risk factor of PBMC HBV rcDNA （OR = 3.896, 95% CI： 1.929-7.876） and PBMC HBV cccDNA （OR = 3.74, 95% CI： 1.186--11.793） in the HBsAg-positive mothers. Administration of hepatitis B immune globulin was a protective factor ofPBMC HBV cccDNA （OR = 0.312, 95% CI： 0.102-0.954） during pregnancy. The positivity ofPBMC HBV rcDNA was related to that of cccDNA in the HBsAg-positive mothers （Zz= 5.087, P = 0.024）. This study suggests that PBMC is a reservoir of HBV and an extrahepatic site for virus replication and plays a critical role in HBV intrauterine transmission.