Vertical Transmission Risk of Hepatitis B: Key Questions for Mothers

The probability of vertical transmission from mother to child with HBsAg positive and HBeAg negative is relatively low, typically estimated to be around 5-10%. However, it is important to monitor and manage the mother's hepatitis B infection to further reduce the risk of transmission?

Hello:
1.
If the mother is HBsAg positive and HBeAg negative, what is the probability of vertical transmission to the child?
2.
If the child has not received hepatitis B immunoglobulin at birth but has completed the first and second doses of the hepatitis B vaccine, when can we determine if the child has developed antibodies or has been infected? (The child is currently 45 days old.)
3.
Recently, I noticed that the child's sclera appears slightly yellow.
Should I seek medical attention immediately? Is there a possibility that the child could be ill without the adults being aware? How can this be prevented?
Thank you for your response!

COCO, 30~39 year old female. Ask Date: 2001/12/29

Dr. Yang Guojun reply Gastroenterology and Hepatology

1.
The chance of transmitting this s+e antigen from mother to offspring exceeds 90%.
2.
Blood tests can be conducted six weeks after the administration of the third dose.
3.
It may simply be physiological jaundice, but a blood test for jaundice can also be performed at a pediatric clinic.
Additionally, children who have been infected with hepatitis B are usually in an immune tolerant phase, meaning they are less likely to experience hepatitis flare-ups.
If acute hepatitis occurs, it often presents with symptoms such as abdominal distension, loss of appetite, and dark-colored urine.

Reply Date: 2001/12/29

More Info

When it comes to Hepatitis B, especially in the context of vertical transmission from mother to child, there are several important considerations and questions that arise. Let's address your queries one by one.

1. Mother's HBsAg and HBeAg Status: If the mother is HBsAg positive and HBeAg negative, the risk of vertical transmission of Hepatitis B to the newborn is lower compared to if she were HBeAg positive. Studies indicate that the risk of transmission can be as low as 1-5% in HBeAg negative mothers, whereas it can be as high as 90% in HBeAg positive mothers. Therefore, while there is still a risk, it is significantly reduced in your case.

2. Timing for Antibody Testing: After the child receives the first two doses of the Hepatitis B vaccine, it is typically recommended to check for the presence of antibodies (anti-HBs) at around 9 to 12 months of age. However, if there are concerns about potential infection, healthcare providers may recommend testing earlier. If the child has received the vaccine but has not been given the Hepatitis B immunoglobulin (HBIG), there is a possibility of infection, and monitoring is crucial.

3. Jaundice in Newborns: If you notice that your child's eyes appear yellow, this could be a sign of jaundice, which is common in newborns but can also indicate liver issues. It is essential to consult a pediatrician immediately if you observe any signs of jaundice, as it may require further evaluation and management. Jaundice can be caused by various factors, including physiological reasons, breastfeeding issues, or more serious liver conditions.

4. Awareness of Infection in Adults: Hepatitis B can be asymptomatic, meaning that adults may not show symptoms even if they are infected. Regular screening and monitoring are essential, especially if there is a known exposure or family history of Hepatitis B. Adults should be aware of their Hepatitis B status and should undergo regular check-ups, including liver function tests and possibly imaging studies, to monitor liver health.

5. Preventive Measures: To minimize the risk of transmission, it is crucial for the mother to maintain regular follow-ups with her healthcare provider. This includes monitoring liver function and viral load. Additionally, ensuring that the newborn receives the appropriate vaccinations and immunoglobulin within 12 hours of birth is vital in preventing infection.
6. Family Vaccination: If there are family members who are unvaccinated or unsure of their Hepatitis B status, it is advisable for them to get tested and vaccinated if necessary. Vaccination is highly effective in preventing Hepatitis B infection.

In conclusion, while the risk of vertical transmission in your case is lower due to the mother's HBeAg negative status, vigilance is essential. Regular pediatric check-ups, timely vaccinations, and awareness of jaundice symptoms are crucial for the health of your newborn. Always consult with healthcare professionals for personalized advice and management based on your family's specific health circumstances.

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