DETECTION OF HEPATITIS B SURFACE ANTIGEN IN PREGNANT WOMEN ATTENDING A PUBLIC HOSPITAL FOR DELIVERY: IMPLICATION FOR

Abstract. Routine antenatal hepatitis B surface antigen (HBsAg) screening and immunization of risk babies is very effective in preventing perinatal transmission of hepatitis B virus (HBV). We studied 1,800 parturients attending a public hospital to assess the rationale for such vaccination in Bangladesh. In one in every 29 deliveries (63 of 1,800 or 3.5%), the mother was found to be HBsAg positive. All were asymptomatic and many (41 of 63 or 65%) without risk factors would remain undetected if HBsAg screening were performed on selected groups. Most of the HBsAg-positive mothers (54 of 63 or 85.7%) were found to be chronic carriers and 30.2 % (19 of 63) were also hepatitis B e antigen (HBeAg) positive, indicating high infectivity. Although 23 cord blood were positive for HBsAg or HBeAg, none were positive for IgM antibody to hepatitis B core antigen (IgM anti-HBc), suggesting transplacental transmis-sion of the antigens rather than intrauterine infection. These findings are discussed in relation to the cost-effectiveness of routine prenatal screening and immunization of risk babies compared with universal infant immunization. Perinatal transmission of hepatitis B virus (HBV) from infected mother to infant often leads to severe long-term sequel. Infants born to mothers positive for both hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) have a 70–90 % chance of acquiring perinatal HBV infection