Author information

¹The Francis Crick Institute, 1 Midland Road, London, NW1 1AT, UK.

²Division of Infection and Immunity, University College London, Gower St, London WC1E 6BT, UK.

³Department of Infection, University College London Hospitals, 235 Euston Rd, London NW1 2BU, UK.

⁴Department of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.

⁵Cooperman Barnabas Medical Center, Florham Park, NJ, USA.

⁶Hepatitis B Foundation, Doylestown, PA, USA.

⁷Department of Paediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

⁸Medical Research Council Clinical Trials Unit, University College London, 90 High Holborn, London WC1V 6LJ, UK.

⁹Chantal Biya International Reference Centre for Research on Prevention and Management of HIV/AIDS (CIRCB), Yaounde, Cameroon.

¹⁰Faculty of Medicine and Biomedical Sciences, University of Yaounde, Yaounde, Cameroon.

¹¹Ministry of Health, Health Surveillance Department, Department of Chronic Diseases and Sexually Transmitted Infections, SRTVN Quadra 701, Lote D, PO700 Building, CEP: 70719-040, Brasília/DF, Brazil.

¹²Universidad Nacional de Colombia, Bogotá, Colombia.

¹³Division of Gastroenterology and Hepatology, NYU Langone Health, NYU Grossman School of Medicine, NY, USA.

¹⁴Center for Disease Analysis Foundation, 1120 W South Boulder Rd Suite 102, Lafayette, CO 80026, USA.

¹⁵Liver Unit, King's College Hospital, Denmark Hill, London SE5 9RS, UK.

¹⁶Division of Hepatology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa.

¹⁷Department of Medicine, Aga Khan University, Karachi, Pakistan.

Abstract

Prevention of mother-to-child transmission of hepatitis B virus (HBV) infection is a cornerstone of efforts to support progress towards elimination of viral hepatitis. Current guidelines recommend maternal screening, antiviral therapy during the third trimester of high-risk pregnancies, universal and timely HBV birth dose vaccination, and post-exposure prophylaxis with hepatitis B immunoglobulin for selected neonates. However, serological and molecular diagnostic testing, treatment and HBV vaccination are not consistently deployed, particularly in many high endemicity settings, and models predict that global targets for reduction in paediatric incidence will not be met by 2030. In this article, we briefly summarise the evidence for current practice and use this as a basis to discuss areas in which prevention of mother-to-child transmission can potentially be enhanced. By reducing health inequities, enhancing pragmatic use of resources, filling data gaps, developing advocacy and education, and seeking consistent investment from multilateral agencies, significant advances can be made to further reduce vertical transmission events, with wide health, societal and economic benefits.