A Public Health Problem
The perinatal transmission of the hepatitis B virus (HBV) poses a serious threat to infants born to mothers infected with the hepatitis B surface antigen (HBsAg). Each year an estimated 22,000 infants are born to women in the United States that are HBsAg positive. The Centers for Disease Control and Prevention (CDC) estimates that approximately 186 women are positive at the time of delivery in Nevada (2008 estimate).
- Infants born to HBsAg positive mothers have a 70% to 90% chance of becoming infected with HBV if not treated at birth.
- As many as 90% of infants infected with HBV may become chronic carriers.
- As high as 25% of these HBV carriers may die in adulthood from cirrhosis or liver cancer.
- Perinatal transmission accounts for 4% of all acute cases of HBV infection.
Background
In 1984, the Advisory Committee on Immunization Practices (ACIP) recommended that all high-risk pregnant women be screened for hepatitis B. In 1988, ACIP, in consultation with the American College of Obstetrics and Gynecology and the American Academy of Pediatrics, recommended that ALL pregnant women be routinely tested for hepatitis B surface antigen (HBsAg) during an early prenatal visit in EACH pregnancy. In 1991, 35% of HBsAg-positive mothers did not report risk factors for hepatitis B, which confirmed the need for universal testing. In 1992, the Nevada State Board of Health adopted regulations requiring the testing of all pregnant women for hepatitis B. In 2005, ACIP reinforced the prior recommendation that all pregnant women be tested for HBsAg during each pregnancy.