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Prevalence of hepatitis B in an indigent, multi-ethnic community clinic prenatal population
1Department of Family Practice, University of California, Davis 95817.
Insights
Hepatitis B virus (HBV) screening in pregnant women identified asymptomatic infections in 5.3% of cases. Ethnicity, particularly Asian ethnicity, was the main predictor of HBV infection, highlighting the need for targeted prenatal screening.
Area of Science:
- Hepatology
- Infectious Diseases
- Public Health
Background:
- Hepatitis B virus (HBV) perinatal transmission is preventable.
- Asymptomatic HBV infection poses a risk to newborns.
- Screening pregnant women is crucial for prevention.
Purpose of the Study:
- To determine the prevalence of asymptomatic HBV infection in a high-risk prenatal population.
- To identify risk factors associated with HBV infection in this population.
- To evaluate the effectiveness of screening in identifying at-risk infants.
Main Methods:
- Chart review of 464 pregnant women from January 1983 to April 1987.
- Hepatitis B surface antigen (HBsAg) screening for HBV infection.
- Logistic regression analysis to assess risk factors.
Main Results:
- Twenty-three (5.3%) pregnant women were HBsAg positive and asymptomatic.
- Ethnicity was the sole significant predictor of HBsAg positivity.
- Asian patients had a 13% HBsAg positivity rate, while Latino subjects had a 1% rate.
- Previous sexually transmitted disease and transfusion history were not predictive.
Conclusions:
- Prenatal screening for asymptomatic HBV infection is effective in identifying a significant number of at-risk infants.
- Ethnicity is a key factor in HBV prevalence within this high-risk population.
- Targeted screening programs are essential for preventing perinatal HBV transmission.
Abstract:
Perinatal infection of hepatitis B virus (HBV) from an infected asymptomatic woman to her offspring is now a preventable disease. A chart review was undertaken to document the prevalence of asymptomatic HBV infection in a high-risk, predominantly minority, indigent, and immigrant family practice clinic population and to evaluate the frequency of accepted known risk factors for those subjects with positive hepatitis B surface antigen (HBsAg) screening tests. Records for 464 pregnant women entering the prenatal program between January 1, 1983, and April 30, 1987, were reviewed. Twenty-three (5.3%) were found positive for the HBsAG, all were asymptomatic. Results of a logistic regression on multiple risk factors for HBV infection revealed that ethnicity was the sole predictor of a positive HBsAg screening test, with 13% of the Asian patients and 1% of the Latino subjects positive for HBsAg. Other historical factors such as previous sexually transmitted disease and past history of transfusion were not predictive. These results reaffirm that a screening program for asymptomatic HBV infection in selected prenatal populations can identify a significant number of infants at risk for risk for perinatal infection.