Factors affecting the compliance of the antenatal hepatitis B screening programme in Italy

Prevalence and etiology of altered liver tests

“…The improvement in hygienic conditions includes the use of more reliable sterilization procedures and disposable medical instruments. The low prevalence of HBsAg (0.8%) in our study is consistent with the results of previous studies [37][38][39] and emphasizes further that Italy currently has a low prevalence of HBsAg without major regional differences.…”

Impact of Hepatitis B Vaccination in Children Born to HBsAg-Positive Mothers: a 20-year Retrospective Study

“…In our population, the anti-HBs mean geometric concentration decreased in relation to time from the vaccination and reached the limit value of 10 mIU/ml after about 15 years from the primary vaccination cycle. Numerous studies have suggested that the antibody decline in immunocompetent subjects is not necessarily related to a loss of protection [3,[13][14][15]. Nevertheless, asymptomatic infection characterized by the presence of anti-HBc in absence of HBsAg viremia (''mild breakthrough infections'') have been documented in vaccinated individuals [10,16].…”

“…Another interesting fact is that only 12.2% of HBsAg-positive mothers were followed in specialized programs, and 35.4% refused follow-up, reflecting our lack of knowledge of the problem in the general population. Moreover, given that immigration from high HBV endemicity areas is steadily increasing, efforts should be made to increase compliance with antenatal HBsAg screening in women coming from these countries [3]. A positive viremia documented in more than 50% of the mothers with a serological profile compatible with ''inactive carrier status'' provides the rationale for clinical follow-up and justifies the need to study these data in terms of its epidemiological significance on infectivity.…”

“…The global prevalence of chronic hepatitis B virus (HBV) infection varies in different geographic areas, with mother-to-child transmission representing one of the major routes of virus acquisition [2]. A national study in Italy showed a hepatitis B surface antigen (HBsAg) prevalence of 1.4% among pregnant women born in Italy and 5.9% among immigrants [3]. Preventive measures are still the best approach to controlling the spread of the virus since is not possible to eradicate HBV infection in the chronic carrier with an effective drug therapy [4].…”

Perinatal transmission of hepatitis B virus: could hospitals be doing more?

“…Now, prenatal screening of pregnant women for HBsAg in the USA is nearly universal [5]; however, routine screening of pregnant women for HBsAg has not yet been conducted in prenatal care programs in some other countries, and even in Western countries, there are still some pregnant women who have never been tested for HBsAg [6,7].…”