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Perinatal Hepatitis B Prevention

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.

Reporting Form:

Physician/Hospital Reporting Form

For more information regarding Perinatal Hepatitis B Prevention Program visit:

Perinatal Hepatitis B Prevention Program (Texas Department of State Health Services)

 

Links & Resources

Viral Hepatitis (Centers for Disease Control and Prevention)

Immunization Action Coalition

Hepatitis B Foundation