Prevention of Perinatal Transmission of the Hepatitis B Virus: Outcome of Infants in a Community Prevention Program

Objective.— To assess the outcome of infants born to hepatitis B surface antigen (HBSAg)-positive mothers who received prenatal and infant care in a large, public health care system. Design.—Follow-up of a cohort of infants born to HBsAg-positive mothers. Setting.—Large, urban hospital providing prenatal care and obstetric services to county health departments. Participants.—Forty-two infants born to HBsAg-positive women. Interventions.—Prental testing of women and immunoprophylaxis of infants with hepatitis B immune globulin at birth and hepatitis B vaccine at birth and ages 1 and 6 months. Results.—All 42 infants received hepatitis B immune globulin and the first dose of vaccine. Of forty-one infants (98%) who received the second dose of vaccine, 37 received it by age 4 months. Thirty-two infants (76%) completed the three-dose vaccine series by age 12 months, and 34 infants (81%) completed the series by age 18 months. The rate of completion of the hepatitis B vaccine series was comparable to that of infants receiving the third dose of diphtheriapertussis-tetanus vaccine. Of 26 infants who completed the hepatitis B vaccine series and had follow-up serologic testing, 24 (92%) had adequate levels of antibody to HBsAg. Only one infant who did not complete the vaccine series had serologic evidence of hepatitis B virus infection. No infant was HBsAg-positive. Conclusions.—Public programs serving urban populations can effectively deliver hepatitis B immunoprophylaxis to infants born to HBsAg-positive mothers.