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Background: Hepatitis B virus infection is an important public health problem worldwide and eliminating mother-to-infant transmission is important to decrease the prevalence of chronic HBV-infection. Although, immunoprophylaxis given at birth largely prevents mother-to-infant transmission, perinatal HBV viremia has been reported in HBsAg(-) newborns born mainly to HBeAg(+) women in endemic areas., Objectives: To examine the incidence of perinatal HBV viremia in newborns of HBsAg(+) predominantly HBeAg(-) mothers., Study Design: Peripheral blood was obtained at birth from 109 HBsAg(+) mothers and their newborns before the administration of active-passive immunoprophylaxis. Infants were prospectively followed and appropriately vaccinated., Results: Although most (92.7%) of the HBsAg(+) mothers were HBeAg(-), 73.4% had detectable HBV viremia. Neonatal viremia was detected in 3/8 (37.5%) and 24/101 (23.8%) newborns of HBeAg(+) and HBeAg(-) mothers, respectively (p=0.386). However, HBV-DNA levels were significantly higher in newborns of HBeAg(+) mothers (p=0.025). No child developed chronic HBV infection, but one child had evidence of subclinical hepatitis., Conclusions: Although the clinical significance of low viremia levels in almost one in four newborns of HBsAg(+) mothers in a low endemicity area is unclear, it may enhance our understanding of HBV mother-to-infant transmission., (Copyright © 2010 Elsevier B.V. All rights reserved.)