PERINATAL HEPATITIS B PREVENTION PROGRAM

Disease Burden of Perinatal Hepatitis B

Each year in the United States approximately 24,000 Hepatitis B surface antigen (HBsAg) positive women give birth¹.  Out of these births, approximately 924 infants will become infected with the Hepatitis B virus from perinatal (mother to baby) transmission[1].  In the District of Columbia, an estimated 39 - 69 births to HBsAg+ women are expected this year[2]. 

Infants are particularly vulnerable as 90% of those infants who get Hepatitis B within the 12 months of birth become chronically infected (for life) and have a higher chance of developing liver cancer or liver failure.  Individuals who become infected with Hepatitis B after five years of age only have a 5% chance of chronic infection.

Prevention of Perinatal Hepatitis B

It is the mission of the District of Columbia Department of Health (DC Health) to identify hepatitis B surface antigen-positive pregnant women or infants at delivery and to work with care providers to administer appropriate treatment to prevent the spread of the hepatitis B virus (HBV).

Recommendations from the Center for Disease Control for perinatal Hepatitis B prevention include:

• Testing and identification of HBsAg+ women early in pregnancy or their infants at delivery and reporting all cases in your practice (regardless of where they reside) to your state Perinatal Hepatitis B Prevention Program (PHBPP) https://www.cdc.gov/vaccines/vpd/hepb/hcp/perinatal-contacts.html.
• Universal birth dose administration of the Hepatitis B vaccine to all infants.
• Administration of Hepatitis B vaccine and Hepatitis B Immune Globulin (HBIG) within 12 hours of birth to infants born to mothers who are HBsAg+ , those mothers of unknown status, or mothers with a past history of Hepatitis B in previous pregnancies but who may currently test negative.
• Vaccination of infants born to HBsAg+ mothers with Hepatitis B vaccine on schedule (birth, 1-2 months, and 6 months).
• Post-vaccine serology testing should be done at 1 – 2 months after the third Hepatitis B vaccine and at least 9 months of age. Testing should include Hepatitis B surface antigen (HBsAg) and Hepatitis B antibody (anti-HB or HBsAb).
• Referral of each perinatal case (prenatal or up to 24 months post-delivery) to the Perinatal Hepatitis B Nurse Case Coordinator for the District of Columbia at 202-576-9325 email: [email protected].  Reporting online link https://octo.quickbase.com/db/bjqtwh8m8?a=er.

Perinatal and Postnatal Hepatitis B Reporting

• Perinatal HIV, Hepatitis B, and Syphilis Reporting Form
• Postnatal and Hepatitis B Case Report and HBIG Report

General Hepatitis Information

DC Department of Health, HIV/AIDS Hepatitis STD Tuberculosis Administration (HAHSTA) http://doh.dc.gov/service/hepatitis

Asian Liver Center http://liver.stanford.edu/

Hepatitis B Foundation Resource Center http://www.hepb.org/patients/

Immunization Action Coalition www.immunize.org

Interpretation of Hepatitis B Serological Results http://www.cdc.gov/hepatitis/hbv/pdfs/serologicchartv8.pdf

HIPPA and Perinatal Hepatitis B Prevention http://www.immunize.org/birthdose/hepb_hipaa.pdf

Perinatal Hepatitis B Prevention and Treatment Information

Guiding principles and tools for perinatal Hepatitis B prevention and treatment are found on the CDC website http://www.cdc.gov/hepatitis/hbv/perinatalxmtn.htm and in the DC Municipal Regulation 22-B Section 207 http://www.dcregs.dc.gov/Gateway/FinalAdoptionHome.aspx?RuleVersionID=950229 .

Link a What Obstetricians Need to Know