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Reuters Health Information (2012-03-29): U.S. program helps cut infant HBV infections

Public Health

U.S. program helps cut infant HBV infections

Last Updated: 2012-03-29 11:43:18 -0400 (Reuters Health)

NEW YORK (Reuters Health) - A program to prevent chronic hepatitis B virus (HBV) infection in newborns seems to be working, according to the Centers for Disease Control and Prevention.

Researchers there found that more babies of HBV-infected women have been vaccinated right away, and fewer have ended up with chronic infections, since the program started in 1990.

"The findings were very encouraging -- they showed that most infants completed the (vaccination) series," said Emily Smith, the lead researcher on the study.

"For the infants that were followed... they had great results and outcomes," she told Reuters Health.

Still, Smith emphasized that there's work to be done in making sure all new mothers with hepatitis B are reported to the CDC's program so that babies can receive the proper care to prevent infection.

About one million people living in the United States have chronic hepatitis B infection, and an additional 40,000 are infected every year.

The National Perinatal Hepatitis B Prevention Program calls for screening all pregnant women for HBV and giving exposed babies antibodies and a vaccine against the virus within 12 hours of birth, followed by an additional two or three vaccine doses over the next year or so.

Individual cities and states submit reports to the CDC on the number of hepatitis B cases identified in women and how their infants were managed, and those numbers are used to make nationwide estimates.

Based on those reports, the researchers calculated that from 1994 to 2008, the number of women who screened positive for HBV each year increased from about 19,000 to close to 26,000.

But health care workers seemed to get better at making sure the babies were protected. Over the study period, the number of exposed babies who got both hepatitis B antibodies and a vaccine within a day of birth increased from 92% to almost 97%.

Along with that, the proportion of exposed infants who ended up with chronic HBV infection fell from 2% to less than 1% by 2008, the researchers reported Monday in Pediatrics.

Still, they were only able to follow about half of babies out to one year. And the number of infants who'd had all of their hepatitis B vaccines by that point actually decreased during the study period -- from 86% to 78% -- with at least some of that due to more families refusing vaccines.

"The program is certainly working -- they're vaccinating more infants successfully," said Dr. Maya Gambarin-Gelwan, who has studied hepatitis B at Weill Cornell Medical College in New York but wasn't involved in the new research.

"But half of the infants who are born to those mothers are slipping through the system essentially," she told Reuters Health. "It's also bothersome that there's this growing percentage of infants who are not completing vaccination or that we don't have a follow-up on."

Smith agreed that not being able to follow infants over time is a problem.

"Women need to receive hepatitis B screening and positive results need to be reported to (the program), to make sure that the infants receive vaccination and care and testing," she said.

Dr. Gambarin-Gelwan added that it's important to get the message out that hepatitis B programs really do work when babies get all of their recommended vaccines, especially to communities with high virus rates, such as among Asian-Americans.

Dr. Tram Tran from Cedars-Sinai Medical Center in Los Angeles told Reuters Health that while rates of screening in early pregnancy are high for women who are already in the health care system, there's still a big gap for other women, such immigrants and illicit drug users.

And even if those women do get screened, she said, they may not have the resources to bring their babies back for the multiple hepatitis B shots necessary for protection.

"It's a completely preventable disease, that's the thing that's frustrating," said Dr. Tran, a hepatitis researcher who wasn't part of the study team.

"We have a vaccine that works really well. It's just getting to these high-risk pockets and these high-risk groups where there's still a lot of opportunity."


Pediatrics 2012.

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