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Screening of pregnant women for hepatitis B
1Public Health Laboratory, Birmingham Heartlands Hospital, Bardesley Green East, UK. lboxall@cdscwmid.demon.co.uk
Insights
Neonatal hepatitis B virus infection is a high risk for infants born to carrier mothers. Universal antenatal screening is crucial for identifying at-risk babies and preventing lifelong hepatitis B infection transmission.
Area of Science:
- Hepatology
- Virology
- Public Health
Background:
- Neonatal hepatitis B virus (HBV) infection poses a significant risk of chronicity.
- Infants born to HBV carrier mothers are highly susceptible to infection during birth.
- Persistent HBV infection in infants establishes a lifelong reservoir, perpetuating community transmission.
Purpose of the Study:
- To highlight the critical need for identifying infants at risk of neonatal hepatitis B virus infection.
- To evaluate various antenatal screening strategies for hepatitis B in pregnant women.
- To discuss the advantages and disadvantages of different screening approaches for HBV prevention.
Main Methods:
- Review of existing literature on antenatal screening strategies for hepatitis B.
- Analysis of different approaches including risk-behavior screening, geographical targeting, serum pooling, and universal screening.
- Discussion of the implications of each strategy on preventing neonatal HBV transmission.
Main Results:
- Infants born to hepatitis B carrier mothers have a very high risk of persistent infection.
- Identifying 'at-risk' infants is only possible through maternal screening during pregnancy.
- Adults have a lower risk (<10%) of becoming chronic HBV carriers compared to neonates.
Conclusions:
- Universal antenatal screening for hepatitis B is essential for preventing neonatal infections.
- Effective screening strategies are key to reducing the incidence and eliminating hepatitis B in the population.
- Preventing persistent infection in infants is paramount to breaking the cycle of HBV transmission.
Abstract:
Neonatal infection with hepatitis B virus carries a very high risk of resulting in a persistent infection. Babies born to hepatitis B carrier mothers are at risk of infection through exposure to blood and body fluids during birth. These 'at risk' babies can only be identified through screening of all mothers during pregnancy. Prevention of infection in this group is a key element in any nation's strategy to reduce the incidence and eventually eliminate hepatitis B infection in its population as the persistently infected infants are a reservoir of infection throughout their lives. The infected adult carries a relatively low risk of becoming a chronic carrier (< 10%). Various strategies for screening in pregnancy have been adopted. These include attempts to identify women with a history of 'risk behaviour', testing only women who were born in areas of high endemicity, pooling of sera and universal antenatal screening. The advantages and disadvantages of the various strategies will be discussed.