Universal Hepatitis B Antibody Screening and Vaccination in Pregnancy

Prabhu, Malavika; Susich, Marguerite; Packer, Claire H.; Hersch, Alyssa R.; Riley, Laura E.; Caughey, Aaron B.

doi:10.1097/aog.0000000000004652

Cited by 9 publications

(6 citation statements)

References 51 publications

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“…This result reflects the worldwide statistics, which estimate that only 39% of infants receive the vaccine birth dose (9), despite the WHO recommendations. Cost‐benefit analysis has induced health care authorities of several countries with low endemicity not to vaccinate infants at birth if the screened mother is HBsAg negative (21) Indeed, this strategy can be very effective to identify newborns in need of HBV‐immunization (19,22).…”

Section: Discussionmentioning

confidence: 99%

Inadequate Hospital Practices to Prevent Mother-to-Child Transmission of Hepatitis B Virus Infection: A European Survey

Pinon

Giugliano

Rocchi

et al. 2023

Journal of Pediatric Gastroenterology &Amp; Nutrition

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Objectives: Prevention of vertical transmission of hepatitis B virus (HBV) infection is crucial to eliminate viral hepatitis as a major public health threat by 2030. We aimed to assess the current hospital policies and practices implemented before, at, and after birth, and to evaluate potential barriers to the full application of international guidelines. Methods: A web-based survey was supported by PENTA Foundation and distributed across Europe from October to December 2021. Results: Overall, 76 centers with delivery departments completed the survey. Hepatitis B surface antigen (HBsAg) maternal screening is performed in the first trimester of pregnancy in 53% of the centers and in the third in 46%. HBsAg positive pregnant women are tested for serologic HBV markers and HBV-DNA in 78% and 63% of the departments; 38% of the HBeAg positive women with high HBV-DNA levels are treated during the last trimester of pregnancy. At birth, 91% of the departments administer HBV vaccine to infants born to HBsAg positive mothers within 12 hours of birth; 74% test women with unknown HBsAg status and 78% of them wait for the maternal testing results before administering HBV vaccine to their newborns. After birth, 47% of the departments provide postvaccination serological testing for infants born to HBsAg positive mothers. The timing of the HBV vaccine schedule varies greatly. Conclusions: There is significant heterogeneity in the hospital policies and correlated procedures. The implementation of a multidisciplinary clinical pathway is a must if a stronger connection between the prenatal, perinatal, and postnatal phases is to be established.

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Section: Discussionmentioning

confidence: 99%

Inadequate Hospital Practices to Prevent Mother-to-Child Transmission of Hepatitis B Virus Infection: A European Survey

Pinon

Giugliano

Rocchi

et al. 2023

Journal of Pediatric Gastroenterology &Amp; Nutrition

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“…Prabhu et al conducted a cost–effectiveness analysis among pregnant women in the USA and found that universal HBV immunity screening and vaccination of susceptible individuals is cost–effective compared to no screening and vaccinating routinely. 24 Although most countries have screened for high-risk groups, the diagnosis rates remain low. In order to resolve this issue, MehlikaUniversal HBsAg screening of adults for chronic hepatitis B(CHB) in the general population of the USA was carried out and found to be cost–effective and potentially cost-saving compared to the current CHB screening recommendations.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the effect of enhanced immunization in adults: A cross-sectional study in the southeast city of China

Ren

Liu

et al. 2022

Human Vaccines & Immunotherapeutics

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The efficacy of hepatitis B vaccination in adults was evaluated by comparison of the positive seroprotection rates and the hepatitis B surface antibody (anti-HBs) geometric mean titers (GMTs) between intensive intervention areas and non-intensive intervention areas after 8 years post-vaccination in the Zhejiang province. Seven cities (towns) in Zhejiang province were selected as intensive intervention areas, and adults in the demonstration areas receive hepatitis B vaccine voluntarily and for free. Other areas were non-intensive intervention areas. A total of 3587 participants received the full vaccination course (three doses), and blood samples were withdrawn 8 years after the first vaccination comprised the immunized group, and 2000 participants constituted the control group. The anti-HBs positive seroprotection rates of the immunized and control groups were 65.0% and 53.0%, respectively. The anti-HBs GMT of the subjects in the immunized group was 26.30 mIU/mL compared to 9.33 mIU/mL in the control group ( P < .001). Significant differences were detected in the 24–35–, 36–45-, and 46–55-year-old subgroups in the positive seroprotection rates and the anti-HBs GMTs ( P < .001) between the immunized and control groups. Moreover, significant differences were found in the anti-HBs GMT in the 46–55-year-old subgroup between the two groups ( P = .02), while no differences were observed in the positive seroprotection rate ( P = .428). In conclusion, adults who did not receive the hepatitis B vaccine in infancy and had negative serological markers of hepatitis B, especially adults <47-years-old, need vaccination.

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“…Pregnant patients should be screened for hepatitis B virus infection at the first prenatal visit of each pregnancy (12,(26)(27)(28). The HBsAg test should always be performed regardless of prior vaccination.…”

Section: Moderate-quality Evidence)mentioning

confidence: 99%

Viral Hepatitis in Pregnancy

Silva

Schiff²

2023

Obstetrics &Amp; Gynecology

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PURPOSE: The purpose of this document is to describe the specific types of viral hepatitis, their implications during pregnancy, the risk of perinatal transmission, and issues related to both treatment and prevention of infection. TARGET POPULATION: Pregnant or postpartum women and individuals who screen positive for viral hepatitis infection. The onset of these conditions may have predated the perinatal period or may have occurred for the first time in pregnancy or the first year postpartum. METHODS: This guideline was developed using an a priori protocol in conjunction with a writing team consisting of one specialist in obstetrics and gynecology appointed by the ACOG Committee on Clinical Practice Guidelines–Obstetrics and one external subject matter expert. ACOG medical librarians completed a comprehensive literature search for primary literature within Cochrane Library, Cochrane Collaboration Registry of Controlled Trials, EMBASE, PubMed, and MEDLINE. Studies that moved forward to the full-text screening stage were assessed by two authors from the writing team based on standardized inclusion and exclusion criteria. Included studies underwent quality assessment, and a modified GRADE (Grading of Recommendations Assessment, Development, and Evaluation) evidence-to-decision framework was applied to interpret and translate the evidence into recommendation statements. RECOMMENDATIONS: This Clinical Practice Guideline includes recommendations on hepatitis B virus and hepatitis C virus screening in pregnancy; prepregnancy, antepartum, intrapartum, and postpartum management for patients with hepatitis B virus infection or hepatitis C virus infection; management of accidental and occupational exposure to hepatitis B virus or hepatitis C virus in pregnant health care workers; and hepatitis A virus and hepatitis B virus vaccination in pregnancy. Recommendations are classified by strength and evidence quality. Ungraded Good Practice Points are included to provide guidance when a formal recommendation could not be made because of inadequate or nonexistent evidence.

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Universal Hepatitis B Antibody Screening and Vaccination in Pregnancy

Cited by 9 publications

References 51 publications

Inadequate Hospital Practices to Prevent Mother-to-Child Transmission of Hepatitis B Virus Infection: A European Survey

Inadequate Hospital Practices to Prevent Mother-to-Child Transmission of Hepatitis B Virus Infection: A European Survey

Evaluation of the effect of enhanced immunization in adults: A cross-sectional study in the southeast city of China

Viral Hepatitis in Pregnancy

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