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Hepatitis B Information for Ob-gyns

NEW! The Immunization Action Coalition (IAC) has announced their newest initiative, Give Birth to the end of Hep B.

Hepatitis B virus (HBV) is a small DNA virus that contains three principal antigens: 1) hepatitis B surface antigen (HBsAg), 2) hepatitis B core antigen, and 3) hepatitis B e antigen (HBeAg). People acutely infected with HBV may be asymptomatic or symptomatic. Among people with symptomatic HBV infection, the spectrum of signs and symptoms is varied and includes subacute illness with nonspecific symptoms (eg, anorexia, nausea, or malaise), clinical hepatitis with jaundice, or fulminant hepatitis. Transmission of HBV occurs through contact with infected blood or bodily fluids (ie, semen, cervical secretions, and saliva).

Perinatal transmission of HBV infection is highly efficient and generally occurs from exposure to maternal blood during labor and delivery. If appropriate and timely treatment is not instituted, perinatal infection occurs in 70–90% of infants born to mothers who are both HBsAG positive and HBeAg positive. Transplacental passage of HBV is rare. More than 90% of infants who are infected perinatally will develop chronic HBV infection.*

*American Academy of Pediatrics, American College of Obstetricians and Gynecologists. Guidelines for perinatal care. 7th ed. Elk Grove Village (IL): AAP; Washington, DC: ACOG; 2012

The hepatitis B vaccine is recommended for all individuals through 18 years of age and all adults who want the vaccine or who are at risk for hepatitis B virus (HBV); the vaccine can be given to pregnant or nursing women. In 2009, 3,374 cases of acute Hepatitis B in the United States were reported to CDC. Because many Hepatitis B viruses are underreported, the estimated approximate rate of infection was 38,000 in the United States in 2009. This represents a significant decline, as new infections have declined by approximately 82% since 1991. It is important to test the hepatitis B status of pregnant women, as mother-baby transmission can be prevented if the mother’s HBV status is known at the time of delivery.

 For more information, visit the CDC's section, Hepatitis B for the health professional.

 Last Updated: 8/5/2013

Hepatitis B Information for Patients

UPDATED!

Hepatitis B virus (HBV) is a contagious infection of the liver. It spreads by contact with the body fluids of someone infected with HBV. Such contact includes having sex or engaging in sexual activity, and sharing drug needles or syringes. Mothers can also pass the infection to their newborns during delivery. HBV infection can cause fever, loss of appetite, nausea and vomiting, stomachache, dark urine, jaundice, and a general feeling of being unwell. These symptoms can be mild or severe. Sometimes, there are no symptoms.

HBV infection can be acute or chronic. Acute HBV infection can incubate in the body for up to 6 months and causes a short-term illness that lasts a few weeks. Sometimes, it can lead to chronic HBV infection. Chronic HBV infection happens when the virus stays in the body. It is a long-term, serious illness that can cause liver cancer, other liver diseases, and other serious health problems. Some people die from chronic HBV infection. The younger a person is at the time of first infection, the higher the risk is of developing chronic infection. Almost 90% of HBV in infants becomes chronic.

The best way to prevent HBV is by getting the vaccine.The Centers for Disease Control and Prevention (CDC) recommends that all infants receive the HBV vaccine. The vaccine is given in a three-shot series beginning at birth. Anyone under age 19 years who has not been previously vaccinated should also receive the HBV vaccination series. Adults older than age 18 years should also get the vaccine if they are at high risk of getting HBV. Individuals in this group include:

• Those who have sex with an infected person, have multiple sex partners, or have a sexually transmitted disease

• Men who have sex with men

• Users of injection drugs who share needles, syringes, or other drug equipment

• Those who live with a person with chronic HBV

• Infants born to infected mothers

• Workers exposed to blood on the job

• Patients who receive blood transfusions or blood products

• Those who travel to or work in countries with increased rates of the disease

HBV vaccine is safe for women who are pregnant or breastfeeding. All pregnant women should be tested for HBV infection prior to vaccination. There are ways to prevent passing the infection to their babies at birth if they test positive.

Visit the CDC's Hepatitis B page for more information.




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