The mission of Collin County Health Care Services Perinatal Hepatitis B Prevention program is to protect the
residents of Collin County through an organized and coordinated delivery approach, tailoring individual and specific
services to facilitate continued support and involvement in educating clients on the risks and prevention of disease
transmission.
This program ensures infants receive the appropriate prophylaxis at birth and complete the necessary vaccine series
and post-vaccine serology testing on time and according to current medical guidelines.
Hepatitis B virus infection is a major cause of acute and chronic hepatitis, cirrhosis of the liver, and the primary
form of liver cancer, hepatocellular carcinoma. Hepatitis B screening of pregnant women has been a state requirement
since September 1, 1999. All providers should test pregnant women during their first prenatal visit and upon
admission for delivery, even if they have been previously vaccinated or tested.
Serology Testing
Delivery hospitals should ensure the infant of a mother who is positive for Hepatitis B virus receives the HBIG
within 12 hours of birth and no later than seven days of age. HBIG is a preventative measure against Hepatitis B
infection and is prepared from plasma containing high titers of Hepatitis B Surface Antibody and provides short term
protection usually from three to six months. Hepatitis B vaccine dose one should be given within 12 hours of birth.
Hepatitis B vaccine dose two should be given at one month of age and Hepatitis B dose three should be given at six
months of age.
Serology testing should be performed three months after the last dose of Hepatitis B vaccination. There are three
markers that must be done by providers to determine if an infant is immune.
Hepatitis B Surface Antigen (HBsAg) is a serologic marker on the surface of the Hepatitis B virus.
It can be detected in high levels in serum during acute or chronic hepatitis. The presence of HBsAg indicates that
the person is infectious. The body typically produces antibodies to HBsAg as part of the normal immune response to
infection. Hepatitis B Surface Antibody (anti-HBs) is generally interpreted as indicating recovery
and immunity from Hepatitis B virus infection, it also develops in a person who has been successfully vaccinated
against Hepatitis B.
Hepatitis B Core Antibody (anti-HBc) appears at the onset of symptoms in acute Hepatitis B and
persists for life. The presence of anti-HBc indicates previous or ongoing infection with Hepatitis B virus in an
undefined time frame.
Some other important markers in determining if a person has been infected are
Hepatitis B e Antigen (HBeAg), a secreted product of the nucleocapsid gene of Hepatitis B virus
which is found in serum during acute and chronic Hepatitis B. Its presence indicates that the virus is replicating
and the infected individual has high levels of Hepatitis B virus.
Hepatitis B e Antibody (HBeAb or anti-HBe) is produced by the immune system temporarily during
acute Hepatitis B virus infection or consistently during or after a burst in viral replication. Spontaneous
conversion from e antigen to e antibody is a predictor for long-term clearance of Hepatitis B virus in patients
undergoing antiviral therapy and indicates lower levels of Hepatitis B virus.
IgM Antibody to Hepatitis B Core Antigen (IgM anti-HBC) positivity indicates recent infection with
Hepatitis B virus and indicates acute infection.
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