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[The importance of screening for hepatitis B surface antigens in pregnancy]
Insights
Preventing perinatal hepatitis B virus (HBV) transmission is crucial. Universal screening of pregnant women and infant vaccination effectively prevented HBV infection in newborns during the study period.
Area of Science:
- Hepatology
- Virology
- Immunology
Context:
- Perinatal transmission of Hepatitis B Virus (HBV) is a highly efficient route of infection, often resulting in chronic carriers.
- Infants born to HBsAg-positive mothers, especially those also HBeAg-positive, face a high risk of infection.
- Chronic HBV infection in infants can lead to severe long-term health issues, including cirrhosis and hepatocellular carcinoma.
Purpose:
- To evaluate the effectiveness of routine screening for Hepatitis B surface antigen (HBsAg) in pregnant women.
- To assess the impact of combined passive (HBIG) and active (HB vaccine) prophylaxis in preventing perinatal HBV transmission.
- To monitor HBV infection rates in infants born to HBsAg-positive mothers.
Summary:
- A screening program identified 22 out of 2744 pregnant women as HBsAg positive.
- Of these, 2 were HBeAg positive, 14 anti-HBe positive, and 6 negative for both markers.
- All infants received HBIG and HB vaccine post-birth, and none were found HBsAg positive at six months.
Impact:
- The implemented screening and vaccination strategy demonstrated success in preventing perinatal HBV transmission.
- This approach offers a viable public health intervention to reduce the burden of chronic hepatitis B.
- Continued observation of this high-risk group is essential to confirm long-term outcomes.
Abstract:
Transmission of hepatitis B virus (HBV) from mother to infant during the perinatal period represents very efficient mode of HBV infection and often leads to severe long-term sequelae. Perinatal transmission can occur when an infant is born to mother positive for hepatitis B surface antigen (HBsAg), frequency of transmission is high if the mother is also HBeAg positive. Prevention of perinatal transmission of HBV is important since the majority of these infants who are infected at birth become chronic carriers and can subsequently develop chronic hepatitis, cirrhosis or primary hepatocellular carcinoma. Routine screening for HBsAg of all pregnant women attending prenatal clinic at the Institute for the Care of Mother and Child, Prague in the third trimester of pregnancy by Sevatest ELISA HBsAg Micro I. method (Sevac, Prague) began in June 1986. HBsAg positive patients were subsequently tested for HBeAg and anti-HBe hepatitis markers. Of the 2744 women examined 22 were found HBsAg positive, of these mostly asymptomatic carrier mothers 2 were positive for HBeAg, 14 for anti HBe and 6 were negative for both HBeAg and anti-HBe. All infants were given passive HBIG prophylaxis in conjunction with HB vaccine after birth regardless of HBeAg status of mother. At present no infant were found HBsAg positive at 6 month of age, observation of this risk group infants continues.