Prevention of vertical transmission of hepatitis B.

[Argirios Argiriou]

July 1, 2014

 
Recommended Measures Prevent Vertical Hepatitis B Transmission

Jamaluddin Moloo, MD, MPH reviewing Kubo A et al. Ann Intern Med 2014 Jun 17.

Prenatal screening and neonatal immunoprophylaxis are effective.

The CDC recommends that pregnant women be screened for hepatitis B virus (HBV) infection and that infants of HBV-positive mothers receive hepatitis B immunoglobulin (HBIg) and vaccine within 12 hours of birth. To evaluate the effectiveness of these practices in a community setting, investigators examined data from a perinatal immunoprophylaxis program at Kaiser Permanente Northern California.

Between 1997 and 2010, 4446 infants were born to mothers who tested positive for hepatitis B surface antigen (HBsAg); 87% of these infants received HBIg and hepatitis B vaccine on schedule. Of 3353 children who underwent follow-up testing by January 2012, 25 (0.75%) were HBsAg positive; all had received HBIg and vaccine within or close to the recommended schedule. All 671 vaccinated children whose mothers were e antigen negative with viral loads <5×107 IU/mL remained negative for HBV infection.


Comment

During the preimmunoprophylaxis era, an estimated 40% of infants born to mothers who were HBV positive developed chronic HBV infection, and transmission rates were 90% among mothers who were positive for hepatitis B e antigen. Results of this community-based study confirm the effectiveness of immunoprophylaxis for preventing vertical transmission of HBV. Further studies are needed to evaluate additional prophylaxis measures (e.g., antiviral treatment during late pregnancy) in e antigen–positive mothers or those with viral loads ≥5×107 IU/mL. Editor Disclosures at Time of Publication Disclosures for Jamaluddin Moloo, MD, MPH at time of publication Grant / Research support Colorado Health Foundation CLOSE

Citation(s): Kubo A et al. Prevention of vertical transmission of hepatitis B: An observational study. Ann Intern Med 2014 Jun 17; 160:828. (Δεν είναι ορατοί οι σύνδεσμοι (links). Εγγραφή ή Είσοδος) -

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