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National Perinatal Hepatitis B Prevention Program: 2009-2017.

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The Perinatal Hepatitis B Prevention Program successfully manages infants born to hepatitis B-positive mothers, increasing identification and post-vaccination testing. Strategies are needed to improve vaccine completion and close identification gaps for hepatitis B prevention.

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Area of Science:

  • Public Health
  • Infectious Diseases
  • Immunization Programs

Background:

  • Hepatitis B virus (HBV) infection poses a significant public health risk, particularly to infants born to infected mothers.
  • The Centers for Disease Control and Prevention's Perinatal Hepatitis B Prevention Program (PHBPP) aims to prevent HBV transmission from mother to infant.
  • Effective case management is crucial for ensuring infants receive timely prophylaxis and vaccination.

Purpose of the Study:

  • To evaluate trends in programmatic outcomes for infants born to hepatitis B surface antigen (HBsAg)-positive women from 2009 to 2017.
  • To assess the effectiveness of the national Perinatal Hepatitis B Prevention Program (PHBPP) in case management and prevention of perinatal HBV transmission.
  • To identify areas for improvement in infant identification, vaccination, and serologic testing.

Main Methods:

  • Analysis of 2009-2017 annual programmatic reports from 56 US jurisdictions funded by the CDC's PHBPP.
  • Assessment of maternal-infant pair characteristics and achievement of infant hepatitis B postexposure prophylaxis, vaccine series completion, and postvaccination serologic testing (PVST).
  • Comparison of identified infants with estimated births using race/ethnicity and maternal country of birth methodologies.

Main Results:

  • The PHBPP identified 103,825 infants born to HBsAg-positive women between 2009 and 2017.
  • The proportion of identified infants increased from 48.1% to 52.6% over the study period.
  • Increases were observed in postexposure prophylaxis (94.7% to 97.0%) and PVST (58.8% to 66.8%), while vaccine series completion saw a smaller increase (83.1% to 84.7%).

Conclusions:

  • The PHBPP demonstrates success in managing infants born to HBsAg-positive women and promoting hepatitis B immunity.
  • Gaps persist between estimated and identified infants, highlighting the need for enhanced surveillance and outreach.
  • Further strategies are required to increase vaccine series completion and ensure universal ordering of recommended PVST for all case-managed infants.