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Folic acid supplementation in pregnant women with hepatitis B surface antigen improves infant hepatitis B surface antibody mediated by infant IL-4

Published online by Cambridge University Press:  25 July 2022

Yandi Li ,
Jia Lian ,
Linzhu Yi ,
Tian Yao ,
Shuying Feng ,
Bo Wang ,
Junli Li ,
Suping Wang Open the ORCID record for Suping Wang [Opens in a new window]  and
Yongliang Feng
Yandi Li
Affiliation:
School of Public Health, Shanxi Medical University, Taiyuan 030001, Shanxi, China Center of Clinical Epidemiology and Evidence Based Medicine, Shanxi Medical University, Taiyuan 030001, Shanxi, China
Jia Lian
Affiliation:
School of Public Health, Shanxi Medical University, Taiyuan 030001, Shanxi, China
Linzhu Yi
Affiliation:
School of Public Health, Shanxi Medical University, Taiyuan 030001, Shanxi, China Center of Clinical Epidemiology and Evidence Based Medicine, Shanxi Medical University, Taiyuan 030001, Shanxi, China
Tian Yao
Affiliation:
School of Public Health, Shanxi Medical University, Taiyuan 030001, Shanxi, China
Shuying Feng
Affiliation:
Department of Obstetrics and Gynaecology, the Third People’s Hospital of Taiyuan, Taiyuan 030012, Shanxi, China
Bo Wang
Affiliation:
Department of Obstetrics and Gynaecology, the Third People’s Hospital of Taiyuan, Taiyuan 030012, Shanxi, China
Junli Li
Affiliation:
First Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi, China
Suping Wang*
Affiliation:
School of Public Health, Shanxi Medical University, Taiyuan 030001, Shanxi, China Center of Clinical Epidemiology and Evidence Based Medicine, Shanxi Medical University, Taiyuan 030001, Shanxi, China
Yongliang Feng*
Affiliation:
School of Public Health, Shanxi Medical University, Taiyuan 030001, Shanxi, China Center of Clinical Epidemiology and Evidence Based Medicine, Shanxi Medical University, Taiyuan 030001, Shanxi, China
*
*Corresponding authors: Suping Wang, email supingwang@sxmu.edu.cn; Yongliang Feng, email yongliang.feng@sxmu.edu.cn
*Corresponding authors: Suping Wang, email supingwang@sxmu.edu.cn; Yongliang Feng, email yongliang.feng@sxmu.edu.cn
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Abstract

Immunoprophylaxis has not completely eliminated hepatitis B virus (HBV) infection due to hyporesponsiveness to hepatitis B vaccine (HepB). We explored the impact of folic acid supplementation (FAS) in pregnant women with positive hepatitis B surface antigen (HBsAg) on their infant hepatitis B surface antibody (anti-HBs) and the mediation effect of infant interleukin-4 (IL-4). We recruited HBsAg-positive mothers and their neonates at baseline. Maternal FAS was obtained via a questionnaire, and neonatal anti-HBs and IL-4 were detected. Follow-up was performed at 11–13 months of age of infants, when anti-HBs and IL-4 were measured. We applied univariate and multivariate analyses. A mediation effect model was performed to explore the mediating role of IL-4. A total of 399 mother–neonate pairs were enrolled and 195 mother–infant pairs were eligible for this analysis. The infant anti-HBs geometric mean concentrations in the maternal FAS group were significnatly higher than those in the no-FAS group (383·8 mIU/ml, 95 % CI: 294·2 mIU/ml to 500·7 mIU/ml v. 217·0 mIU/ml, 95 % CI: 147·0 mIU/ml to 320·4 mIU/ml, z = –3·2, P = 0·001). Infants born to women who took folic acid (FA) within the first trimester were more likely to have high anti-HBs titres (adjusted β-value = 194·1, P = 0·003). The fold change in IL-4 from neonates to infants partially mediated the beneficial influence of maternal FAS on infant anti-HBs (24·7 % mediation effect) after adjusting for confounding factors. FAS during the first trimester to HBsAg-positive mothers could facilitate higher anti-HBs levels in infants aged 11–13 months partly by upregulating IL-4 in infants.

Keywords

Hepatitis B virusFolic acidIL-4ImmunisationMediation effect
Type
Research Article
Information
British Journal of Nutrition , Volume 129 , Issue 10 , 28 May 2023 , pp. 1812 - 1819
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Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of The Nutrition Society

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