Prevention strategy for father-to-child transmission of hepatitis B virus: a systematic review and meta-analysis.

Objective: Father-to-child transmission (FTCT) occurs in infants born to hepatitis B virus (HBV) infected father. In this study, we aim to summarize the prevention strategy for FTCT of HBV by systematic review and meta-analysis.

Methods: PubMed and China Knowledge Resource Integrated Database were systematically searched. We systematically reviewed the prevention strategy for father, mother, and infant before, during pregnancy and after birth. We also examined trial sequential analysis (TSA) for the required information size (RIS).

Results: Fourteen studies with 2825 father-mother-child pairs included in the studies. Two publications assessed father antiretroviral therapy before pregnancy, with the mean FTCT incidence 3.5% in the antiretroviral therapy group and 12.0% in the control group. The summary OR compared between two groups was 0.280 (95% CI 157-0.500; Z = 4.30, p < .00001) by random-effects model. TSA showed further studies were needed. Twelve publications assessed maternal immunoprophylaxis before and during pregnancy, with the mean FTCT incidence 14.9% in the maternal immunoprophylaxis group and 32.8% in the control group. The summary OR compared between two groups was 0.343 (95% CI 252-0.468; Z = 6.77, p < .00001) by random-effects model. TSA showed no further studies were needed. No randomized controlled trials (RCT) and non-RCTs were found assessing neonate and infant immunoprophylaxis for FTCT prevention.

Conclusion: Father antiretroviral therapy before pregnancy, maternal immunoprophylaxis before and during pregnancy, and neonate and infant immunoprophylaxis are important prevention strategy for FTCT of HBV. However, this conclusion should be confirmed by high quality randomized controlled trials.