Has a program managing infants exposed to hepatitis B been successful?

Hepatitis B is no longer a disease that needs to run its course, thanks in large part to a highly effective vaccine. However, some infants are delivered to mothers who are hepatitis B surface antigen (HBsAg)–positive. An investigation published in Pediatrics assessed the outcomes of infants who were born to HBsAg-positive mothers and were case-managed by the Centers for Disease Control and Prevention’s national Perinatal Hepatitis B Prevention Program.¹

The researchers looked at the annual programmatic reports that were submitted by 56 jurisdictions in the United States from 2009 to 2017. The reports looked at infant hepatitis B postexposure prophylaxis, vaccine series completion, and postvaccination serologic testing. They also compared the number of mother-infant pairs in the program with the number of infants estimated to be born to HBsAg-positive women from 2009 to 2014 and 2015 to 2017.

The Perinatal Hepatitis B Prevention Program found 103,825 infants born from 2009 to 2017 who had mothers who were HBsAg-positive, an annual range of 10,956 to 12,103 infants. The estimated births to HBsAg-positive women nonsignificantly increased from 24,804 in 2009 to 26,444 in 2014 (P = .0540) and 20,678 in 2015 to 20,832 in 2017 (P = .8509). Over the same period of time, the ratio of infants who were identified annually increased from 48.1% to 52.6% (P = .0983). Among the case-managed infants, the proportion who received postexposure prophylaxis, at least 3 vaccine doses, and postvaccination serologic testing also increased from 94.7% to 97.0% (P = .0952), 83.1% to 84.7% (P = .5377) and 58.8% to 66.8% (P = .0002), respectively.

The results of the analysis indicate that the Perinatal Hepatitis B Prevention Program has been successfully managing the infants born to HBsAg-positive women as well as ensuring that the infants achieve immunity to hepatitis B. The researchers did note that public health officials and clinicians need to develop strategies to close the gap between the number of infants who are estimated and the number who are identified. Additionally, they need to also work on increasing vaccine series completion and postvaccination serologic testing in case-managed infants.

Reference

1. Koneru A, Fenlon N, Schillie S, Williams C, Weng M, Nelson N. National perinatal hepatitis b prevention program: 2009–2017. Pediatrics. February 2, 2021. Epub ahead of print. doi:10.1542/peds.2020-1823