Implementation of Strategies to Prevent Mother-to-child Transmission of Hepatitis B Virus Infection, Thailand, 2016–2017

Abstract

Mother-to-child transmission (MTCT) of hepatitis B virus can cause chronic liver disease. Thailand aimed to eliminate MTCT of hepatitis B virus by 2025. Strategies include hepatitis B surface antigen (HBsAg) screening for pregnant women, antiviral therapy for infected mother, hepatitis B birth dose vaccination (HepB-BD), HBV immunoglobulin (HBIG) administration and post-vaccination serologic testing (PVST) for infants born to HBsAg-positive mother. The objectives of this study were to assess the management of HBsAg-positive mothers and their infants. We reviewed medical records of HBsAg-positive pregnant women and their infants born during 1 Jan 2016–31 Dec 2017 at 14 hospitals in seven provinces to assess the percentage of women who were tested and treated for HBV and the percentage of infants born to them who received HepB-BD, HBIG and underwent PVST. All 69,303 pregnant women were screened for HBsAg and 1,179 (1.7%) were HBsAg positive. Of 1,179 HBsAg-positive women, 219 (18.6%) were tested for hepatitis B e-antigen (HBeAg) and 85 (38.8%) were HBeAg positive; 29 (2.5%) were tested for HBV DNA and 14 (48.3%) had viral load ≥200,000 IU/mL. Of 90 women eligible for antiviral therapy, 16 (17.8%) received treatment. Among 1,144 infants with available records, HepB-BD and HBIG coverage was 99.3% and 45.8%. Of 966 children with follow-up records, 12.2% underwent PVST and all were HBsAg negative. In conclusion, while the coverage of maternal HBsAg screening and infant HepB-BD was high, few women received follow-up testing and treatment. HBIG administration for infants was low and PVST rate still needed improvement.

Keywords:  hepatitis B virus, hepatitis B infection, mother-to-child transmission, Thailand