Is hepatitis B virus transmitted via the male germ line? A seroepidemiological study in fetuses

Objectives: To detect father-to-fetus transmission of hepatitis B virus (HBV) in utero. Methods: We conducted a study at the prenatal diagnosis center of Taizhou City. Fetuses with one or both parents carrying the hepatitis B surface antigen (HBsAg) were identified before genetic testing during the period 2008-2010. Intrauterine samples were obtained by amniocentesis or cordocentesis and tested for serological markers and by quantitative DNA assays. All neonates received combined hepatitis B immunoprophylaxis after delivery, and serological follow-up tests were performed at 1 year of age. Results: Of the 407 couples enrolled in the study, HBV was carried by fathers only in 164, and none of their fetuses were found to be HBV DNA-positive in utero. All fetal serological markers were found to be of maternal but not paternal origin. The response rate to postnatal vaccination was 98.6%, and none of the children who failed immunoprophylaxis were the offspring of the HBV carrier fathers. Conclusions: The infection of fetuses with HBV from the spermatozoa of carrier fathers seems unlikely, especially in an area where pre-conception hepatitis B vaccination is routinely provided. (C) 2012 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.