Maternal Transmission of Hepatitis B Surface Antigen in Patients with Hepatocellular Carcinoma in Taiwan

To determine the source of the highly prevalent hepatitis B virus (HBV) infection in our patients with hepatocellular carcinoma (HCC), we examined hepatitis B surface antigen (HBsAg) and its subtypes and antibody in 11 patients with HCC and their parents. All the patients were positive for HBsAg. Eight (73%) of the mothers were also HBsAg-positive, whereas only one of the seven fathers was an HBsAg carrier (P = 0.025). The observation is compatible with maternal transmission as a source of HBV infection in most of our patients with HCC. The subtype was identifiable in 10 patients, 9 with HBsAg/adw and one with adr. The subtype was identical in the patient--mother carrier pairs, suggesting that HBV infection in the patient and the mother is intimately related. This is further evidenced by the observation of a relatively uncommon adr subtype in one patient--mother pair. These observations suggest that the HBV infection in our patients results from vertical transmission from their carrier mothers probably long before the development of HCC.