Evaluation Prevention Perinatal Hepatitis B virus (HBV)-transmission

Abstract

Pregnant women who are infected with the hepatitis B virus (HBV), have a high risk of infecting their baby with the virus. To prevent this, these children are vaccinated several times and receive antibodies directly after birth. Research by the RIVM shows that these interventions prevent the transmission of this virus in most of the cases (99.4%). This research was commissioned by the Ministry of VWS, to evaluate the effectiveness of these HBV-immunisations and compare the different immunisation schemes that have been recommended since 2003. The vaccination programme for this high risk group exists since 1989. HBV is transmitted during pregnancy and/or delivery from mother to child, by bloodblood or mucosal contact and by sexual contact. HBV can cause liver cirrhosis and liver cancer.

Results
For this research the results of the last three year of the programme were evaluated; from previous years the results have already been reported. Between July 1st, 2007 and May 2011, 1187 children were included from HBV-infected mothers. Their blood was tested for the presence of the HBV and for the level of antibodies. Parents were asked to fill in a questionnaire. Of the 1017 children with a blood test result, there were four HBV-infected (0.4%). In these four children the protective measures had not been effective. Of the remaining children no blood was received.

We also evaluated the results of the entire study period (January 1st, 2003 to May 2011). Of the 3311 children who were invited, the blood results were available for 2864 children. Of these, 16 were HBV-infected (0.6%).

Continuation of serological testing for children born to HBV-infected women
Considering the high effectiveness of the vaccine (99.4% of the vaccinated children were not infected), VWS decided from a public health perspective to stop the programme to test children born to HBV-infected women. However, it continues to be recommended to test vaccinated children born to HBV-infected mothers for HBV infection and immunity. This would benefit the health of the children who are nevertheless infected and may need treatment. Since January 1st, 2011 the responsibility for the serological test is transferred to the child's general practitioner.