Hepatitis B Surface Antigen Screening Among Pregnant Women and Care of Infants of Hepatitis B Surface Antigen–Positive Mothers — Guam, 2014

Abstract

What is already known about this topic? Hepatitis B virus (HBV) infection is endemic in the U.S. territory of Guam, and perinatal transmission is a major mode of transmission. The Advisory Committee on Immunization Practices recommends that all pregnant women be screened for hepatitis B surface antigen (HBsAg) in each pregnancy and that infants of HBsAg-positive women receive postexposure prophylaxis (PEP) with hepatitis B vaccine and hepatitis B immune globulin (HBIG) within 12 hours of birth to reduce the risk for perinatal HBV transmission. What is added by this report? In a hospital-based random sample of women with a live birth during 2014 in Guam, HBsAg seroprevalence (2.0%) was approximately 13 times higher than that among U.S.-born Pacific Islander and Asian women (0.14%) and approximately twice the overall U.S. maternal prevalence estimate (0.9%). Approximately 90% of HBsAg-positive women were born before introduction of universal infant hepatitis B vaccination. Among women who had at least one prenatal care visit, 98% received prenatal HBsAg screening, compared with 85% of women who did not receive prenatal care. All infants of HBsAg-positive women received hepatitis B vaccine and all but one infant received HBIG. What are the implications for public health practice? Prenatal HBSAg screening facilitates prompt identification of HBsAg-positive pregnant women and mitigates the risk for perinatal HBV transmission. Timely administration of PEP to infants of HBsAg-positive women is important to prevent perinatal HBV transmission.