Risk factors and predictive model for hepatitis B virus deoxyribonucleic acid elevation in mid-to-late pregnancy with low viremia

doi:10.4254/wjh.124577

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World Journal of Hepatology

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1948-5182

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Hepatol. Oct 27, 2026; 18(10): 124577
Published online Oct 27, 2026. doi: 10.4254/wjh.124577

Table 1 General characteristics of elevated and non-elevated groups, n (%)

Factor	Total cases (n = 430)	Non-elevation group (n = 272)	Elevation group (n = 158)	P value
Parity				0.343
Primiparous	236 (54.88)	154 (56.62)	82 (51.90)
Multiparous	194 (45.12)	118 (43.38)	76 (48.10)
BMI (kg/m²)	20.59 (19.05, 22.71)	20.55 (19.10, 22.67)	20.85 (18.99, 22.79)	0.623
< 18.5	73 (16.98)	42 (15.44)	31 (19.62)	0.652
18.5 ≤ BMI < 24	294 (68.37)	188 (69.12)	106 (67.09)
24 ≤ BMI < 28	53 (12.33)	36 (13.24)	17 (10.76)
≥ 28	10 (2.32)	6 (2.20)	4 (2.53)
Age	31.00 (28.00, 34.00)	31.00 (28.00, 34.00)	32.00 (29.00, 35.00)	0.075
≤ 30	179 (41.63)	120 (44.12)	59 (37.34)
> 30	251 (58.37)	152 (55.88)	99 (62.66)

BMI: Body mass index.

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Table 2 Clinical characteristics of elevated and non-elevated groups, n (%)

Factor	Total cases (n = 430)	Non-elevated groups (n = 272)	Elevated groups (n = 158)	P value
HBeAg				0.021
Negative	402 (93.49)	260 (95.59)	142 (89.87)
Positive	28 (6.51)	12 (4.41)	16 (10.13)
HBV DNA (IU/mL)				< 0.001
< 100	228 (53.02)	181 (66.54)	47 (29.75)
≥ 100	202 (46.98)	91 (33.46)	111 (70.25)
TBA, µmol/L	2.60 (1.46, 4.25)	2.60 (1.40, 4.00)	2.65 (1.80, 4.45)	0.454
TBIL, µmol/L	5.75 (4.38, 7.62)	5.80 (4.25, 7.80)	5.65 (4.38, 7.50)	0.530
DBIL, µmol/L	2.50 (1.91, 3.12)	2.50 (2.00, 3.20)	2.50 (1.90, 3.10)	0.697
IBIL, µmol/L	3.10 (2.20, 4.70)	3.10 (2.20, 4.95)	3.10 (2.15, 4.55)	0.636
AST, U/L	15.50 (13.50, 19.60)	15.40 (13.20, 19.60)	16.20 (13.60, 19.60)	0.643
AST < 19	251 (58.37)	159 (58.46)	92 (58.23)	0.352
AST ≥ 19	100 (23.26)	58 (21.32)	42 (26.58)
ALT, U/L	13.60 (9.80, 18.88)	13.60 (9.75, 18.75)	13.50 (9.75, 18.91)	0.915
ALT < 19	232 (53.95)	140 (51.47)	92 (58.23)	0.958
ALT ≥ 19	75 (17.44)	45 (16.54)	30 (18.99)
TP, g/L	65.71 ± 4.29	65.43 ± 3.85	66.04 ± 4.81	0.555
ALB, g/L	36.10 ± 3.81	36.11 ± 3.76	35.80 ± 3.92	0.980
GLB, g/L	30.30 ± 3.20	29.95 ± 318	30.68 ± 3.22	0.343
HGB, g/L	120.00 (113.00, 127.00)	120.00 (113.00, 127.75)	120.00 (113.50, 126.00)	0.662
PLT, × 10⁹/L	230.00 (201.00, 263.25)	232.00 (201.00, 264.00)	226.00 (201.50, 263.00)	0.644
WBC, × 10⁹/L	8.61 (7.54, 10.20)	8.60 (7.58, 10.39)	8.61 (7.36, 9.82)	0.455
TC, mmol/L	4.73 (4.12, 5.26)	4.69 (4.13, 5.23)	4.83 (4.06, 5.33)	0.622
TG, mmol/L	1.39 (1.12, 1.82)	1.44 (1.17, 1.87)	1.28 (1.03, 1.68)	0.025
HDL-C, mmol/L	1.71 ± 0.29	1.70 ± 0.28	1.72 ± 0.61	0.678
LDL-C, mmol/L	2.36 (2.02, 2.76)	2.36 (2.10, 2.70)	2.38 (1.90, 2.81)	0.920
HbA1c, %	5.10 (5.00, 5.30)	5.10 (5.00, 5.30)	5.10 (4.90, 5.30)	0.429
< 6.0	276 (64.19)	177 (65.07)	99 (62.66)	0.060
≥ 6.0	2 (0.47)	0 (0)	2 (1.27)
Cr, µmol/L	49.00 (44.00, 54.00)	48.70 (43.00, 54.00)	50.00 (44.00, 55.00)	0.333
PT, seconds	12.50 (11.10, 12.90)	12.40 (11.20, 12.88)	12.50 (11.05, 13.000	0.339
APTT, seconds	32.40 (28.80, 34.70)	32.45 (28.85, 34.78)	32.20 (28.80, 34.70)	0.883
INR	0.95 (0.92, 0.99)	0.95 (0.92, 0.99)	0.96 (0.92, 0.99)	0.380

HBeAg: Hepatitis B virus e antigen; HBV DNA: Hepatitis B virus deoxyribonucleic acid; TBA: Total bile acid; TBIL: Total bilirubin; DBIL: Direct bilirubin; IBIL: Indirect bilirubin; AST: Aspartate aminotransferase; ALT: Alanine aminotransferase; TP: Total protein; ALB: Albumin; GLB: Globulin; HGB: Hemoglobin; PLT: Platelet; WBC: White blood cell; TC: Total cholesterol; TG: Triglyceride; HDL-C: High-density lipoprotein cholesterol; LDL-C: Low-density lipoprotein cholesterol; HbA1c: Glycated hemoglobin; Cr: Creatinine; PT: Prothrombin time; APTT: Activated partial thromboplastin time; INR: International normalized ratio.

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Table 3 One-way logistic analysis of hepatitis B virus DNA elevation in mid- to late-term pregnancy

Factor	Β	SE	Wald	OR (95%CI)	P value
Parity	0.133	0.150	0.786	1.14 (0.85-1.53)	0.375
BMI (kg/m²)	0.014	0.034	0.174	1.01 (0.95-1.09)	0.677
Age	0.049	0.024	4.393	1.05 (1.00-1.10)	0.036
HBeAg positive	0.893	0.396	5.083	2.44 (1.12-5.30)	0.024
HBV DNA ≥ 100 IU/mL	1.547	0.216	51.139	4.70 (3.07-7.18)	< 0.001
TBA, µmol/L	0.027	0.037	0.508	1.03 (0.95-1.11)	0.476
TBIL, µmol/L	-0.008	0.031	0.060	0.99 (0.93-1.05)	0.807
DBIL, µmol/L	-0.023	0.098	0.057	0.98 (0.81-1.18)	0.812
IBIL, µmol/L	-0.022	0.033	0.423	0.98 (0.92-1.04)	0.515
AST ≥ 19 U/L	0.224	0.241	0.865	1.25 (0.78-2.01)	0.352
ALT ≥ 19 U/L	0.014	0.271	0.003	1.01 (0.60-1.73)	0.958
TP, g/L	0.034	0.056	0.359	1.03 (0.93-1.15)	0.549
ALB, g/L	-0.002	0.058	0.001	1.00 (0.89-1.12)	0.979
GLB, g/L	0.073	0.076	0.913	1.08 (0.93-1.25)	0.339
HGB, g/L	0.009	0.009	1.036	1.01 (0.99-1.03)	0.309
PLT, × 10⁹/L	0.000	0.002	0.007	1.00 (0.99-1.01)	0.933
WBC, × 10⁹/L	-0.036	0.054	0.445	0.96 (0.87-1.07)	0.505
TC, mmol/L	0.042	0.139	0.091	1.04 (0.79-1.37)	0.763
TG, mmol/L	-0.475	0.251	3.596	0.62 (0.38-1.02)	0.058
HDL-C, mmol/L	0.206	0.493	0.175	1.23 (0.47-3.23)	0.676
LDL-C, mmol/L	-0.047	0.147	0.102	0.95 (0.72-1.27)	0.750
HbA1c, %	-0.413	0.344	1.443	0.66 (0.34-1.30)	0.230
Cr, µmol/L	0.009	0.015	0.345	1.01 (0.98-1.04)	0.557
PT, seconds	0.097	0.111	0.773	1.10 (0.89-1.37)	0.379
APTT, seconds	-0.015	0.021	0.488	0.99 (0.95-1.03)	0.485
INR	2.882	2.072	1.934	17.85 (0.31-1036.05)	0.164

OR: Odds ratio; CI: Confidence interval; BMI: Body mass index; HBeAg: Hepatitis B virus e antigen; HBV DNA: Hepatitis B virus deoxyribonucleic acid; TBA: Total bile acid; TBIL: Total bilirubin; DBIL: Direct bilirubin; IBIL: Indirect bilirubin; AST: Aspartate aminotransferase; ALT: Alanine aminotransferase; TP: Total protein; ALB: Albumin; GLB: Globulin; HGB: Hemoglobin; PLT: Platelet; WBC: White blood cell; TC: Total cholesterol; TG: Triglyceride; HDL-C: High-density lipoprotein cholesterol; LDL-C: Low-density lipoprotein cholesterol; HbA1c: Glycated hemoglobin; Cr: Creatinine; PT: Prothrombin time; APTT: Activated partial thromboplastin time; INR: International normalized ratio.

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Table 4 Number of cases with different hepatitis B virus DNA baselines and hepatitis B virus DNA changes, n (%)

Range of change in HBV DNA¹	HBV DNA < 100 (n = 227)	100 ≤ HBV DNA < 1 × 10⁴ (n = 172)	HBV DNA ≥ 1 × 10⁴ (n = 31)
Rising and ≥ 2 × 10⁵	0 (0)	8 (4.65)	11 (35.48)
Rising but < 2 × 10⁵	46 (20.26)	85 (49.42)	8 (25.81)
Decreasing or unchanged	181 (79.74)	79 (45.93)	12 (38.71)

¹Hepatitis B virus DNA (IU/mL).

HBV: Hepatitis B virus.

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Table 5 Hepatitis B virus DNA elevated to high-risk pregnant women and neonatal follow-up outcomes

Case number	Prevention of MTCT during pregnancy	Timing of MTCT	Standard hepatitis B vaccination	Breastfeeding duration	HBsAg
1	No	-	Finish	1 month	Negative
2	No	-	Finish	12 months	Negative
3	No	-	Finish	1 month	Negative
4	Yes	32 weeks of gestation	Finish	8 months	Negative
5	No	-	Finish	3 months	Negative
6	No	-	Finish	4 months	Negative
7	No	-	Finish	0 months	Negative
8	Yes	28 weeks of gestation	Finish	5 months	Negative
9	Yes	26 weeks of gestation	Finish	8 months	Negative
10	Yes	31 weeks of gestation	Finish	8 months	Negative
11	-	-	-	-	-
12	No	-	Finish	2 months	Negative
13	Yes	31 weeks of gestation	Finish	24 months	Negative
14	No	-	Finish	7 months	Negative
15	No	-	Finish	9 months	Negative
16	No	-	Finish	8 months	Negative
17	No	-	Finish	1 month	Negative
18	No	-	Finish	5 days	Negative
19	No	-	Finish	6 months	Negative

MTCT: Mother-to-child transmission; HBsAg: Hepatitis B surface antigen.

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Citation: Chen Z, Chen H, Jie B, Peng T, Lin Y, Geng Y, Shen Y, Deng Y, Xie D, Yang L, Ouyang S. Risk factors and predictive model for hepatitis B virus deoxyribonucleic acid elevation in mid-to-late pregnancy with low viremia. World J Hepatol 2026; 18(10): 124577
URL: https://www.wjgnet.com/1948-5182/full/v18/i10/124577.htm
DOI: https://dx.doi.org/10.4254/wjh.124577

Chen Z, Chen H, Jie B, Peng T, Lin Y, Geng Y, Shen Y, Deng Y, Xie D, Yang L, Ouyang S. Risk factors and predictive model for hepatitis B virus deoxyribonucleic acid elevation in mid-to-late pregnancy with low viremia. World J Hepatol 2026; 18(10): 124577 [DOI: 10.4254/wjh.124577]

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