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Prevention of perinatal hepatitis B virus transmission: are we following guidelines?
Peter G Markey1, Helena A White2, Alexander T Matthews3
1Head of Surveillance Centre for Disease Control Northern Territory Department of Health Darwin.
Insights
Infants born to mothers with hepatitis B show good adherence to the four-dose vaccine schedule. However, follow-up serological testing for hepatitis B infection is insufficient, requiring improved systems.
Area of Science:
- Immunology
- Pediatrics
- Public Health
Background:
- Infants born to mothers with hepatitis B infection require timely vaccination and serological monitoring.
- Current guidelines recommend serological review after completing a four-dose hepatitis B vaccine schedule for these infants.
Purpose of the Study:
- To evaluate the proportion of neonates receiving hepatitis B immunoglobulin who completed their vaccination schedule.
- To assess the rate of documented follow-up serological testing in this high-risk infant population.
Main Methods:
- Retrospective review of 102 neonates who received hepatitis B immunoglobulin.
- Analysis of vaccination records and documented serology results for 66 infants.
- Tracing of infants with undocumented serology for primary care testing.
Main Results:
- High adherence to the four-dose hepatitis B vaccination schedule was observed (98.5% received four doses).
- Only 29% of infants had documented follow-up serology results.
- One infant was found to be infected, and one was immune through infection clearance.
Conclusions:
- Vaccination schedule adherence is strong in infants born to mothers with hepatitis B.
- Significant gaps exist in the documented follow-up serological testing for hepatitis B.
- Strengthening systems to ensure timely serological testing is crucial for this vulnerable group.
Abstract:
It is recommended that infants born to women with hepatitis B infection should have serological review following completion of a four dose vaccination schedule. A review was undertaken on 102 neonates who received hepatitis B immunoglobulin to ascertain the proportion that were fully immunised and then followed up. Of the 66 infants for whom data were available, 65 (98.5%) had appropriately received four doses of hepatitis B vaccine in infancy and a further child had received three doses. Only 19/66 (29%; 95%CI: 18-41%) infants had documented follow-up serology results, one of whom was infected and one of whom was immune through clearance of infection. All children who had no serology documented were traced and offered testing in primary care. Our results demonstrate that although adherence to the vaccination schedule in this group of infants was good, mechanisms for ensuring that infants receive serology testing need to be strengthened.
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