Hepatitis B in the newborn

Question 1

maternal mangement

Answer 1

maternal hepatitis B; fetal complications
Management for HBsAg-positive mothers
In mild disease and/or low HBV DNA levels, therapy may be delayed until after birth
In severe disease; nucleoside/nucleotide analogs (especially tenofovir)
spontaneous vaginal delivery possible

Question 2

Newborn immunization

Answer 2

within 12 hours of birth (first dose of hepatitis B vaccine series plus 1 dose of HBIG)
Breastfeeding: allowed as long as passive‑active postexposure prophylaxis was given

Question 3

Infected newborns:

Answer 3

Usually asymptomatic, but up to 90% risk developing chronic infection and significant risk of cirrhosis and progression to hepatocellular carcinoma if left untreated

Question 4

diagnosis

Answer 4

Serum studies:
Normal or only slightly elevated transaminases
High viral replication rate
Interferon therapy is contraindicated during pregnancy!