Perinatal Hepatitis B Information for Clinicians

Universal hepatitis B birth dose and screening of all pregnant women for hepatitis B has been recommended nationally since 1991. As a result, the U.S. has seen a 99% decline in pediatric hepatitis B infections.

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Transmission

The most common cause of perinatal HBV infection is when a pregnant mother with HBV infection gives birth, and the infant does not receive the HepB vaccine birth dose and the hepatitis B immune globulin (HBIG) within 12 hours of birth. An infant can also develop HBV infection through contact with blood or other bodily fluids from a person with HBV infection.

HBV can be transmitted by HBV-positive fathers, who are not routinely tested during pregnancy or at birth, and in group settings such as daycares. HBV can live on surfaces for up to seven (7) days, even on everyday items like shared toothbrushes that may contain traces of blood. The risk of horizontal transmission is especially high for people living in the same household as someone with chronic HBV infection.

Asymptomatic transmission: HBV infection can occur with or without symptoms, and about half of infected adults do not realize they have the disease. Because of this, adults who are unaware of their infection may unintentionally transmit HBV to infants, children, and immunocompromised individuals. HBV infection in pregnant women and infants can be identified through a confirmed positive HBsAg test result. If an acute hepatitis B infection does not resolve on its own, it can progress to chronic hepatitis, cirrhosis, or hepatocellular carcinoma.

Chronic HBV

The risk for chronic HBV infection varies according to the age at infection and is greatest among young children. Approximately 90% of infants with HBV infection and 30% of children between 1 and 5 years of age with HBV infection will develop a chronic HBV infection.

Hepatitis B in pregnancy is a Class 2 reportable condition in Mississippi and must be reported to MSDH within one week of diagnosis. This includes HBsAg-positive results in pregnancy.

Additional Resources

Information from the CDC:

• Clinical Overview of Perinatal Hepatitis B
• Hepatitis B Perinatal Vaccine Information
• Clinical Testing and Diagnosis for Hepatitis B
• Clinical Signs and Symptoms of Hepatitis B