Preventing perinatal hepatitis B transmission can improve the overall quality of health care for women with chronic hepatitis B and move closer toward the goal of eliminating perinatal hepatitis B transmission in the United States.
RN, MPH Every year, 25,000 women with chronic hepatitis B infection give birth, according to the Centers for Disease Control and Prevention (CDC). They are a subset of the estimated 700,000 to 1.4 million people chronically infected with hepatitis B virus in the U.S., but merit our special attention because of the risk of perinatal hepatitis B infection, which occurs when the virus is transmitted from a mother to her infant. Although such transmission is completely preventable, an estimated 952 infants in the U.S. were infected perinatally in 2009, the most recent year for which estimates are available.
Given the relatively small, yet stubbornly persistent number of perinatal hepatitis B infections in the U.S., the national Viral Hepatitis Action Plan (Action Plan) set as one of its overarching goals the elimination of perinatal hepatitis B transmission in the U.S. by 2020. The steady annual number of perinatal hepatitis B cases is particularly concerning because approximately 90% of HBV-infected newborns develop chronic infection; up to 25% of these children will die of cirrhosis, liver failure, or liver cancer later in life.
A key to achieving that goal is ensuring that all pregnant women are tested for hepatitis B so that appropriate interventions can be taken upon the birth of the infant to a mother who tests positive for chronic hepatitis B infection–specifically, the provision of post-exposure prophylaxis (i.e., hepatitis B immune globulin and hepatitis B vaccine) to all infants born to HBV-infected women.
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