By Corinna Dan, R.N., M.P.H
Since May is Hepatitis Awareness Month, it is an excellent opportunity to focus on actions that can be taken to improve the health and well-being of mothers and their infants. I would like to highlight perinatal hepatitis B transmission and the actions needed to eliminate this preventable disease. An estimated 1.4 million Americans are living with chronic (lifelong) hepatitis B virus (HBV) infection.
Most of them do not know that they are infected; placing them at greater risk for severe, even fatal, complications from the disease. For infected and undiagnosed mothers, this increases the likelihood that they will spread HBV to their infants. One of the main goals of the Action Plan for the Prevention, Care and Treatment of Viral Hepatitis is the elimination of mother-to-infant transmission of the hepatitis B virus.
Mothers Can Make a Difference When It Comes to Hepatitis B
We have the tools to eliminate perinatal hepatitis B trans-mission in the United States: a safe and effective vaccine that protects those who receive it from infection; accurate, inexpensive blood tests to identify those with hepatitis B virus infection; prevention for babies born to chronically infected mothers; and treatments that can reduce the amount of virus in the body and prevent transmission of the virus to others. Despite these effective tools, the CDC estimates that 1,000 infants are chronically infected with hepatitis B each year in the United States. Fifteen to 25 percent of these infants will die prematurely from liver failure or liver cancer. This is a prevent-able disease so hereâs what every mother should know in order to prevent hepatitis B.
Pregnant Women Should Be Tested for Chronic Hepatitis B
All pregnant women should be tested for hepatitis B infection as part of their regular prenatal care. In 1988, the CDCâs Advisory Committee on Immunization Practices recommended that all pregnant women get screened for the hepatitis B surface antigen (Bag) to ensure that all infants born to HBsAg-positive women get the recommended hepatitis B immune globulin (HBIG) shot and the first dose of the hepatitis B vaccine within 12 hours of birth. This combination is up to 95 percent effective in preventing perinatal chronic hepatitis B infect-ion.
Infants Should Be Vaccinated to Prevent Hepatitis B
The hepatitis B vaccine is recommended for all infants. CDC recommends that the infant get the first shot before leaving the hospital. The three-dose series gives long-term protectionâpossibly lifelongâand can prevent hepatitis B infection and its serious consequences including liver cancer and cirrhosis (scarring) of the liver. Hepatitis B virus is easily spread through contact with the blood or other body fluids of an infected person. People can also be infected from contact with a contaminated object, where the virus can live for up to seven days. Infants and children are typically not aware of the dangers of blood exposure but the hepatitis B vaccine protects them even if they are ex-posed to another personâs blood. Unfortunately, the goal of eliminating perinatal hepatitis B transmission has not been achieved, largely because of incomplete coverage of newborns with this birth dose of hepatitis B vaccine.
Mothers who learn they have hepatitis B can get help, too. Hepatitis B is a treatable condition requiring regular check-ups and sometimes medication, just like many chronic conditions. By taking care of themselves, mothers with hepatitis B can help to ensure that they will be there to nurture and watch their children grow.
What You Can Do
If you are an expectant mother, discuss the results of your hepatitis B test with your healthcare provider. If you learn you are living with hepatitis B, talk with your provider about the steps necessary to protect your baby at birth.
If you know an expectant mother, encourage her to learn more about hepatitis B and the steps she can take to protect her baby from HBV.
If you are a healthcare provider, make sure you are screening all pregnant women and individuals at risk for chronic hepatitis B. Check out the CDCâs recommendations for testing for chronic hepatitis B and additional information for health professionals.
Knowledge is power, and two places you can visit to learn more about hepatitis B and babies are the Office of Womenâs Health Hepatitis Page and this CDC fact sheet (PDF 863 KB). On this Mothers Day during Hepatitis Awareness Month, we hope that you will take the opportunity to learn about hepatitis B: how to protect your children and take care of yourself as we work together to eliminate mother-to-infant transmission of hepatitis B.
By Corinna Dan, R.N., M.P.H., Viral Hepatitis Policy Advisor, Office of HIV/AIDS and Infectious Disease Policy, U.S. Department of Health and Human Services
