Perinatal Hepatitis-B Prevention - Home

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.

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.

Perinatal Hepatitis B Prevention - Policies

The Nevada Division of Public and Behavioral Health and Nevada's local health districts are required by Nevada Revised Statute (NRS), Nevada Administrative Code (NAC) and guidelines established by CDC, to investigate and control the spread of Hepatitis B virus via the vertical and horizontal routes of transmission.

Nevada's Perinatal Hepatitis B Program in conjunction with local health districts, hospitals, obstetricians, pediatricians, and other prenatal providers operate with the following 4 components:

1. Identify high-risk infants by routinely screening all pregnant women for HBsAg during each pregnancy.
2. Administer hepatitis B vaccine to all newborns and Hepatitis B Immune Globulin (HBIG) to high-risk infants within 12 hours of delivery.
3. Assure completion of the 3 to 4 dose hepatitis B vaccine series and the post-vaccination testing for HBsAg and quantitative HBsAB.
4. Assure that all susceptible contacts of HBV-infected pregnant women are identified and offered vaccination.