Routine Prenatal Screening for Hepatitis B Surface Antigen

Transmission of the hepatitis B virus (HBV) during the perinatal period leads to the most devastating consequences of HBV infection. Women who test positive for hepatitis B surface antigen (HBsAg) at the time of delivery and who have hepatitis B e antigen in their sera have a 70% or greater chance of transmitting infection to their newborn infants. At least 90% of these infected infants become HBV chronic carriers. These HBV-carrier children have a 25% lifetime risk of dying from primary hepatocellular carcinoma or cirrhosis, usually during adulthood.¹In addition, they serve as a reservoir of HBV infection in their families and communities. Many become carrier mothers themselves and perpetuate the cycle of perinatal transmission. Fortunately, treatment of these newborns shortly after birth with a combination of hepatitis B immune globulin and hepatitis B vaccine is 85% to 95% effective in preventing development of the HBV—chronic carrier state.²