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Perinatal transmission of hepatitis B virus and its prevention
1Department of Paediatrics, Faculty of Medicine, Tottori University, Yonago, Japan. shirakik.hi-ho.ne.jp.
Insights
Preventing infant Hepatitis B virus (HBV) infection is crucial to avoid liver cirrhosis and cancer. Screening pregnant women and vaccinating newborns are key strategies to block mother-to-infant HBV transmission.
Area of Science:
- Hepatology
- Immunology
- Public Health
Background:
- Hepatitis B virus (HBV) infection in infants can lead to severe liver diseases like cirrhosis and hepatocellular carcinoma later in life.
- Maternal chronic HBV infection, particularly with hepatitis B e-antigen (HBeAg) positivity, poses a high risk (80-90%) of vertical transmission to newborns.
- Mothers positive for anti-HBe have a lower risk, but newborns can still develop acute or fulminant hepatitis.
Purpose of the Study:
- To highlight the critical importance of preventing mother-to-infant HBV transmission.
- To outline essential screening and prophylactic measures for newborns at risk of HBV infection.
- To advocate for universal vaccination strategies in high-endemic regions.
Main Methods:
- Screening of pregnant women for hepatitis B surface antigen (HBsAg).
- Administration of hepatitis B immune globulin (HBIG) at birth to at-risk infants.
- Initiation of the hepatitis B vaccine series for newborns shortly after birth.
- Consideration of universal HBV vaccination for all newborns in highly endemic areas.
Main Results:
- Maternal HBsAg screening identifies infants at risk of HBV infection.
- Post-exposure prophylaxis with HBIG and timely vaccination significantly reduces HBV transmission rates.
- Universal newborn vaccination is an effective strategy in areas with high HBV endemicity.
Conclusions:
- Preventing infant HBV infection is essential for long-term liver health, preventing cirrhosis and cancer.
- A combined approach of maternal screening, infant prophylaxis (HBIG and vaccination), is vital for preventing mother-to-child transmission.
- Universal HBV vaccination of all newborns is strongly recommended in highly endemic regions to control HBV spread.
Abstract:
In order to prevent liver cirrhosis and hepatocellular carcinoma in later life, it is essential to prevent HBV infection in infants. If the mother is chronically infected with HBV and is also positive for HBeAg, 80-90% of the newborns become chronically infected, whereas if the mother is positive for anti-HBe, only some newborns will develop acute hepatitis or fulminant hepatitis. It is necessary to screen pregnant women for HBsAg and prevent mother-to-infant infection of HBV, treating the infant with hepatitis B hyperimmune globulin at birth, followed by HBV vaccination. In highly endemic areas of HBV, universal HBV vaccination of all newborns is advisable.