Pediatrics

A 45 day old infant developed icterus and two days later symptoms and signs of acute liver failure appeared. Child was found to be positive for HbsAg. The mother was also HBsAg carrier. The mother’s hepatitis B serological profile is likely to be:

Name: A 45 day old infant developed icterus and two days later symptoms and signs of acute liver failure appeared. Child was found to be positive for HbsAg. The mother was also HBsAg carrier. The mother’s hepatitis B serological profile is likely to be:
Published: 2024-04-12T13:24:22+05:30
Keywords: Pediatrics

💡 Explanation

## **Core Concept**
The question revolves around the transmission of hepatitis B virus (HBV) from mother to child and the interpretation of serological profiles in hepatitis B infection. The key concept here is understanding the serological markers of HBV infection and their implications in mother-to-child transmission.

## **Why the Correct Answer is Right**
The infant's presentation with icterus and acute liver failure at 47 days of age, along with being HBsAg positive, strongly suggests perinatal transmission of HBV from the mother. In cases of perinatal transmission, the mother is usually a carrier of the virus, indicated by the presence of HBsAg. The serological profile of the mother being HBsAg positive suggests she is infectious. For the mother to transmit HBV to her child, she would likely be HBeAg positive (indicating high viral replication and infectivity) and have a profile that indicates active viral replication.

## **Why Each Wrong Option is Incorrect**
- **Option A:** This option suggests the mother is immune due to vaccination or past infection (anti-HBs positive) and does not match the scenario of transmitting HBV to her child.
- **Option B:** This profile indicates a chronic infection with low viral replication (HBeAg negative, anti-HBe positive), making it less likely for the transmission to occur.
- **Option D:** This profile suggests an acute infection or an inactive carrier state with no viral replication (anti-HBe positive), which does not align well with the high infectivity needed for perinatal transmission.

## **Clinical Pearl / High-Yield Fact**
A crucial point to remember is that the risk of mother-to-child transmission of HBV is significantly reduced if the mother receives antiviral prophylaxis during pregnancy or if the newborn receives hepatitis B immune globulin and the first dose of hepatitis B vaccine at birth. The serological profile **HBeAg positive, HBsAg positive, anti-HBc positive, anti-HBe negative, and anti-HBs negative** indicates a highly infectious carrier state.

## **Correct Answer:** .

✓ Correct Answer: B. HbsAg and HbeAg positivity

A 45 day old infant developed icterus and two days later symptoms and signs of acute liver failure appeared. Child was found to be positive for HbsAg. The mother was also HBsAg carrier. The mother’s hepatitis B serological profile is likely to be:

A 45 day old infant developed icterus and two days later symptoms and signs of acute liver failure appeared. Child was found to be positive for HbsAg. The mother was also HBsAg carrier. The mother’s hepatitis B serological profile is likely to be:

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