Abstract: Objective To elaborate on the feasibility strategy for achieving "zero mother-to-child transmission (MTCT) of HBV". Methods This retrospective study was performed in the Second Affiliated Hospital of Southeast University from January 2005 to December 2015 to evaluate the effects of the strategy of eliminating mother-to-child HBV transmission and to summarize the high-risk factors of mother-to-child transmission. Result No cases of mother-to-child HBV transmission were found if hepatitis B surface antigen (HBsAg) or hepatitis B e antigen (HBeAg) positive mothers with HBV DNA, have HBV DNA was less than 1.0×10⁶copies/ml. If mothers with HBV DNA levels above 1.0×10⁸copies/ml managed with oral use of telbivudine or tenofovir to implement antiviral therapy from 28 weeks of gestation, there are also no cases of mother-to-child HBV transmission were found. HBV mother-to-child transmission occurred only in HBV DNA>1.0×10⁶copies/ml and case of not implementing antiviral therapy during pregnancy. After a birth dose of hepatitis B immunoglobulin (HBIG), in combination with hepatitis B vaccine (HepB), was used for infants born to HBV infected mothers and check the hepatitis B surface antibody (HBsAb) for infants at 2 months, 7 months and 12 months, a replenish of HepB was given to strengthen the vaccine if infants with HBsAb titer was less than 100. Conclusion HBV DNA load is a key predictor of mother-to-child HBV transmission. Antiviral treatment of nucleoside analogs in pregnant women with high HBV DNA load can be effective. The combination of immunization and enhanced follow-up for infants with a low response to HepB, and strengthen vaccination if necessary to block mother-to-child transmission, can achieve “zero mother-to-child HBV transmission”.

Key words: Hepatitis B virus, Intrauterine infection, Zero transmission, Infant, Neonatal