Transmission from mother to baby is one of the most common ways for the hepatitis B virus (HBV) to spread. In the United States, an estimated 24,000 women per year give birth while infected with HBV, according to a report by Dr. D. M. Roque and colleagues at the Centers for Disease Control and Prevention. The Advisory Committee on Immunization Practices recommended that these babies receive hepatitis B vaccine and hepatitis B immune globulin within 12 hours of birth, followed by completion of the 3-dose HepB series. The Hepatitis B Foundation provides more information on these vaccinations on its website.
Vaccines against HBV have been available since 1982, but the disease remains “one of the most prevalent yet most neglected health problems in the world,” reported Dr. Stephanie D. Chao of the Stanford school of Medicine in California. Asians and Asian Americans are disproportionately affected. In the United States, approximately half of the 1.2 to 2 million people with chronic hepatitis B are Asian or Pacific Islanders. Transmission from mother to newborn accounts for up to 40 percent of HBV infection in this population. Fewer than 75 percent of these babies complete the vaccination series. “These failures to comply with CDC recommendations may be due, in part, to a pervasive lack of awareness and knowledge among first-line health care providers.”
Chronic hepatitis B infection typically has no symptoms, Chao noted, until serious liver damage has been done. Untreated cases have a 25 percent risk of death from liver cancer or liver failure. Thus, infected individuals should get liver cancer screening with ultrasound and a blood test for alpha-fetoprotein.
The risk of liver cancer from HBV infection was reviewed by Dr. Morris Sherman of University of Toronto, Canada. Individuals with high viral loads are the ones most likely to develop hepatocellular carcinoma, the most common type of liver cancer. Antiviral therapy can significantly reduce the risk.
1. Centers for Disease Control and Prevention, MMWR Morbidity and Mortality Weekly Report 2011 April 8; 60(13): 410-13.