Chronic hepatitis B infection in an Australian antenatal population: seroprevalence and opportunities for better outcomes

BACKGROUND: In the antenatal population, screening for Hepatitis B virus (HBV) carrier status is routinely undertaken to guide preventative measures for the newborn. There is scarce information in the literature, however, regarding the subsequent management of Hepatitis B surface antigen (HBsAg) positive mothers. AIMS AND METHODS: Thus, we undertook this retrospective study to (i) determine the prevalence of HBsAg positivity among mothers attending two teaching hospital birth centers; (ii) determine whether HBsAg mothers received HBV education and underwent further evaluation of HBV infectivity status; and (iii) determine whether these mothers had further follow up for HBV infection post delivery. RESULTS: Between January 2003 and December 2006, 14, 857 mothers were screened for hepatitis B virus infection. Among these, 295 mothers were positive with HBsAg seroprevalence of 2%. A more detailed review of the available 206 medical records revealed that the majority (78%) had previous documentation of infection in earlier pregnancies. However none had received education regarding HBV infectivity. In addition, liver function tests were only performed in 78% of the mothers while Hepatitis B e antigen was tested in 65% of cases. Further, 93% of the mothers had no documentation of further follow up plans or referrals for their HBV infection. CONCLUSION: It is clear that chronic HBV infection is prevalent in the antenatal population. However, there are no strategies to ensure that infected mothers subsequently undergo further education for HBV or evaluation of infectivity. Clearly strategies are required to ensure improved follow up of hepatitis B infected mothers.