Practice Advisory: Hepatitis B Prevention

Question 1

Pregnant women positive for hepatitis B surface antigen (HBsAg) should be tested for

Answer 1

hepatitis B virus deoxyribonucleic acid (HBV DNA) to guide the use of antiviral medication to prevent perinatal transmission

Question 2

The American Association for the Study of Liver Diseases suggests antiviral therapy for pregnant women with HBV DNA >200,000 IU/mL (7.6 log10 IU/mL). Published evidence indicates that maternal antiviral therapy during pregnancy further reduces perinatal HBV transmission (2,3,4,5)

Answer 2

> 200,000

Question 3

The CDC now recommends universal hepatitis B vaccination within 24 hours of birth for medically stable infants >2000 grams, removing permissive language that allowed the vaccine to be delayed until after hospital discharge, and continues to recommend hepatitis B vaccination and hepatitis immune globulin regardless of birth weight within 12 hours of birth for infants born to hepatitis b-infected mothers. Both of these recommendations are consistent with ACOG and AAP’s

Answer 3

hepatitis B vaccine and
hepatitis B immune globulin
regardless of weight within 12 hours of birth for infants born to hepatitis b infected mothers.