Minnesota Hepatitis B Perinatal Prevention Program
Hepatitis B virus (HBV) infection is a major public health problem in the United States and the world. There are approximately 300,000 new cases in the U.S. each year, one third of which are acquired through perinatal or early childhood transmission. Up to 90% of the individuals who acquire the infection at birth will become chronic carriers of hepatitis B if left untreated. Chronic carriers can develop chronic liver disease, cirrhosis of the liver, or primary liver cancer.
In 1988, the United States Public Health Service Immunization Practices Advisory Committee (ACIP) recommended that all pregnant women be screened for hepatitis B surface antigen (HBsAg). At this time, all pregnant women should have HBsAg testing as part of the prenatal profile. The Centers for Disease Control (CDC) estimates that this will identify nearly 19,000 women who are hepatitis B carriers (46% Southeast Asian, 21% white, 19% black, 11% Hispanic, and 3% other). The cost effectiveness of universal HBsAg screening of pregnant women compares with other prenatal and neonatal screening programs (including hypothyroidism and phenylketonuria).
The Minnesota Department of Health (MDH) implemented a hepatitis B perinatal prevention program in 1990 (funded through CDC). The strategies which follow are recommended as part of this program.
To prevent perinatal transmission:
- Screen all women early in pregnancy for HBsAg. If the woman's lifestyle or clinical symptoms are suspicious of acute hepatitis, additional HBsAg serology should be performed later in the pregnancy.
- Document the results of the HBsAg serology in the patient's prenatal record, hospital chart, and in the patient's immunization record card. MDH can provide cards to be used for this purpose.
- Provide educational materials to those women determined to be acutely infected or chronic carriers of the virus. MDH has pamphlets available at no charge.
- Administer hepatitis B immune globulin (HBIG) and HBV vaccine at birth to all infants born to carrier mothers. The HBV vaccine should also be administered at 1 and 6 months of age. Postvaccination serology should be completed 3 to 9 months after the final dose of vaccine. Document in the patient's chart and personal immunization record.
- Susceptible household members and other close contacts should also be vaccinated. MDH vaccine is available for these clients.
MDH - Acute Disease Prevention Services - Perinatal Hepatitis B Program