Real-world efficacy of comprehensive measures against mother-to-child transmission of HBV in south-eastern Jiangsu, China

Reducing mother-to-child transmission (MTCT) is the crucial step towards eliminating hepatitis B virus (HBV) infection. The aim of this study is to evaluate the efficiency of intervention programme to MTCT of HBV in China and establish a foundation for future clinical practice and policy formulation. A retrospective cross-sectional study was conducted and data was collected from the iPMTCT Programme. From January 2021 and June 2024, the puerpera of hepatitis B surface antigen (HBsAg) infection and infants born to HBsAg-positive mothers in Nantong city were enrolled in this study. In puerpera, the screening rate, HBsAg prevalence rate and antiviral treatment rate were analyzed. In infants, administration of combined immunoprophylaxis, MTCT rate and relative factors of MTCT were analyzed respectively. From January 2021 and June 2024, 99,391 pregnant women received HBV screening and 2797 of them were tested positive for HBsAg. The overall HBsAg prevalence of pregnant women steadily dropped from 3.03% to 2.62%. The overwhelming majority of newborns born to HBsAg-positive mothers were immunized with HepB and HBIG timely after birth and got post-vaccination serologic testing (PVST)after completing three-dose vaccine. MTCT rate of at-risk neonates also exhibited a declining trend following the implementation of interventions (from 0.55% to 0.29%). Logistic analysis indicated that antiviral therapy of pregnant women with high-viral load (HBV DNA ≥ 2 × 10^5) served as an independent protective factor against preventing MTCT (OR = 0.091; 95% CI: 0.01 ~ 0.821, P < 0.05). The implementation of comprehensive measures against MTCT of HBV achieves remarkable progress and laid the root for achieving the HBV elimination goals in China.