Perinatal Hepatitis B Prevention Program

What is the Perinatal Hepatitis B Prevention Program (PHBPP)?

Women who are pregnant and infected with the hepatitis B virus can transmit the infection to their infants at birth.  The purpose of the PHBPP is to coordinate with the birthing hospital to ensure the infant receives the appropriate post-exposure prophylaxis at birth.  The program also coordinates with the infant’s immunization provider to be sure the infant receives their additional doses of hepatitis B vaccine.  After the infant receives all of their recommended doses of hepatitis B vaccine a blood draw is completed at 9-12 months of age.  The infant is tested to be sure they acquired immunity to hepatitis B through the immunizations and that they did not acquire the hepatitis B infection from their mother.

What is the goal of the PHBPP?

The primary goal is to reduce the incidence of hepatitis B in infants born to women with hepatitis B.

How is this goal achieved?

• First, HBsAg-positive pregnant women must be identified:

  • By screening all pregnant women for hepatitis B (HBsAg) during each pregnancy, even if they have been previously tested or vaccinated.  See CDC’s testing algorithm.
  • By re-screening women, who are at an increased risk of hepatitis B, for HBsAg at the time of delivery.  This is regardless of a negative result early on in their pregnancy. 
  • By reporting all HBsAg-positive pregnant women to the health department during their pregnancy and at the time of their delivery.

  A follow-up system is in place to help ensure that infants born to HBsAg-positive women receive appropriate post-exposure prophylaxis.

  In addition, all household and sexual contacts of pregnant women with hepatitis B should be tested for hepatitis B.  If susceptible, contacts should receive the 3-dose series of hepatitis B vaccine.

How and when do pregnant women with hepatitis B (HBsAg-positive) get reported?

Hepatitis B in pregnant women is a legally notifiable condition and should be reported within one working day to the health department.  All pregnant women who are HBsAg-positive should be reported to the health department as early in their pregnancy as possible.

Ways to report a HBsAg-positive pregnant woman to Northern Nevada Public Health:

• Fax a copy of the HBsAg-positive test result along with the Confidential Case Report form (filled out completely) to the confidential fax at (775) 328-3764.
• Call the Communicable Disease Program at (775) 328-2447.

What is the appropriate post-exposure prophylaxis for infants born to HBsAg-positive women?

Hepatitis B immune globulin (HBIG) and the first dose of hepatitis B vaccine are given within 12 hours of birth. There are 2-3 additional doses of hepatitis B vaccine given depending on if the infant is receiving a combination vaccine (3 additional doses) or single antigen vaccine (2 additional doses). Doses are given at 2, 4 and 6 months for combination vaccine and 1-2 months and 6 months for single antigen. The last dose should not be given before the infant is 6 months of age.

What about follow-up blood testing of these infants?

Infants born to HBsAg-positive women should receive post-vaccination serological testing. This screens for HBsAg (to see if they have hepatitis B) and anti-HBs (to see if they have adequate protection against hepatitis B).This follow-up testing should be done at 9-12 months of age. Testing should not be completed prior to 9 months of age.

Questions about the PHBPP?

Contact the Communicable Disease Program at (775) 328-2447.

The above contact number can also be used to report vaccine doses and test results on infants and household contacts of women enrolled in the program.

All information is general in nature and is not intended to be used as a substitute for appropriate professional advice.

Additional Resources

Nevada State Health Division - Hepatitis Prevention and Control Program

Perinatal Transmission | HBV | Division of Viral Hepatitis | CDC

Patient Education Resources | HBV | Division of Viral Hepatitis | CDC