Prevention of perinatal transmission of the hepatitis B virus. Outcome of infants in a community prevention program
M. T. Niu, P. V. Targonski, B. J. Stoll, G. P. Albert and H. S. Margolis
Hepatitis Branch, Centers for Disease Control, Atlanta, GA 30333.
OBJECTIVE. To assess the outcome of infants born to hepatitis B surface
antigen (HBsAg)-positive mothers who received prenatal and infant care in a
large, public health care system. DESIGN. Follow-up of a cohort of infants
born to HBsAg-positive mothers. SETTING. Large, urban hospital providing
prenatal care and obstetric services to county health departments.
PARTICIPANTS. Forty-two infants born to HBsAg-positive women.
INTERVENTIONS. Prenatal testing of women and immunoprophylaxis of infants
with hepatitis B immune globulin at birth and hepatitis B vaccine at birth
and ages 1 and 6 months. RESULTS. All 42 infants received hepatitis B
immune globulin and the first dose of vaccine. Of forty-one infants (98%)
who received the second dose of vaccine, 37 received it by age 4 months.
Thirty-two infants (76%) completed the three-dose vaccine series by age 12
months, and 34 infants (81%) completed the series by age 18 months. The
rate of completion of the hepatitis B vaccine series was comparable to that
of infants receiving the third dose of diphtheria-pertussis-tetanus
vaccine. Of 26 infants who completed the hepatitis B vaccine series and had
follow-up serologic testing, 24 (92%) had adequate levels of antibody to
HBsAg. Only one infant who did not complete the vaccine series had
serologic evidence of hepatitis B virus infection. No infant was
HBsAg-positive. CONCLUSIONS. Public programs serving urban populations can
effectively deliver hepatitis B immunoprophylaxis to infants born to
HBsAg-positive mothers.
