Antenatal hepatitis B in a large teaching NHS Trust - implications for future care

Area of Science:

• Hepatology
• Virology
• Public Health

Background:

• Vertical transmission of hepatitis B virus (HBV) remains a global health concern.
• Antenatal antiviral prophylaxis is increasingly considered for HBsAg-positive pregnant women.
• Assessing the workload associated with these new guidelines is essential for healthcare planning.

Purpose of the Study:

• To determine the expected workload from introducing antenatal antivirals for preventing vertical HBV transmission.
• To evaluate the uptake of HBV vaccination and serology testing in infants born to HBsAg-positive mothers.
• To identify factors influencing clinic disengagement among HBsAg-positive women.

Main Methods:

• Retrospective review of HBsAg-positive women and their infants (2005-2011) in a UK teaching NHS Trust.
• Analysis of pregnancies, infant outcomes, vaccination, and serology completion rates.
• Assessment of maternal referral and clinic follow-up rates across diverse ethnic groups.

Main Results:

• Approximately 7% of pregnancies involved mothers who met criteria for antenatal antivirals.
• 176 infants were born to 140 HBsAg-positive women; 1.1% experienced vertical transmission.
• High rates of infant vaccination (81.1%) and serology testing (79.5%) were observed, despite 30% maternal clinic disengagement.

Conclusions:

• Newly published criteria for antenatal antiviral treatment apply to a small proportion of HBsAg-positive women.
• Effective community engagement strategies are vital to improve adherence and outcomes across diverse ethnic groups.
• Strengthening healthcare pathways is necessary to reduce HBV transmission and ensure comprehensive care for mothers and infants.