Correlations between Breast Milk HBsAg, Serum HBsAg, and Serum HBV DNA in Women with Chronic HBV Infection

Background: The aim is to investigate the correlations between breast milk HBsAg and hepatitis B serological markers and HBV DNA. Methods: Two hundred and twelve women with chronic HBV infection were recruited in our hospital from March 2019 to October 2019. Enzyme-linked immunosorbent assay (ELISA) and chemiluminescence microparticle immunoassay (CMIA) were used to measure HBsAg content. Serum HBsAg was determined by electrochemiluminescence. Real-time PCR was used to detect serum HBV DNA. The chi-squared test and nonparametric test were used for statistical analysis. Spearman's rank correlation test was used to measure the degree of association between variables. Results: In comparison to patients positive for HbsAg, anti-HBe antibody, and anti-HBc antibody, the patients positive for HBsAg, HBeAg, and anti-HBc antibody had significantly higher breast milk HBsAg content. Besides, patients with higher serum HBsAg levels also had higher breast milk HBsAg content than those with medium and low serum HBsAg levels. Patients with higher serum HBV DNA had higher breast milk HBsAg content than those with medium and low serum HBV DNA. The correlation analysis revealed a positive correlation between serum HBsAg and serum HBV DNA. In patients with serum HBV DNA >= 20 IU/mL, breast milk HBsAg content was positively correlated to serum HBV DNA. Breast milk HBsAg content was positively correlated with the serum HBsAg level. Additionally, the sensitivity of ELISA was significantly lower than CMIA in the detection of breast milk HBsAg. Conclusions: HBsAg content in breast milk is positively correlated with serum HBsAg level and HBV DNA load. CMIA is more sensitive than ELISA in the detection of breast milk HBsAg. Serum HBsAg level and HBV DNA load are useful for forecasting breast milk HBsAg content. (Clin. Lab. 2022;68:xx-xx. DOI: 10.7754/Clin.Lab.2021.210641)