Pediatrics: Perinatal Hepatitis B Prevention: Eliminating Disease and Disparity

COMMENTARY: Esther K. Chung, Daniel A. Enquobahrie. Perinatal Hepatitis B Prevention: Eliminating Disease and DisparityPediatrics, Feb 2021, e2020037549; DOI: 10.1542/peds.2020-037549

ORIGINAL ARTICLE: Koneru et. al, National Perinatal Hepatitis B Prevention Program: 2009–2017. Pediatrics, Feb 2021, e20201823; DOI: 10.1542/peds.2020-1823

OBJECTIVES: To assess trends and programmatic outcomes among infants born to hepatitis B surface antigen (HBsAg)–positive women from 2009 to 2017 and case-managed by the Centers for Disease Control and Prevention’s national Perinatal Hepatitis B Prevention Program (PHBPP).

METHODS: We analyzed 2009–2017 annual programmatic reports submitted by 56 US jurisdictions funded through the Centers for Disease Control and Prevention’s PHBPP to assess characteristics of maternal-infant pairs and achievement of objectives of infant hepatitis B postexposure prophylaxis, vaccine series completion, and postvaccination serologic testing (PVST). We compared the number of maternal-infant pairs identified by the program with the number estimated born to HBsAg-positive women from 2009 to 2014 and 2015 to 2017 by using a race and/or ethnicity and maternal country of birth methodology, respectively.

RESULTS: The PHBPP identified 103 825 infants born to HBsAg-positive women from 2009 to 2017, with a range of 10 956 to 12 103 infants annually. Births estimated annually to HBsAg-positive women increased nonsignificantly from 24 804 in 2009 to 26 444 in 2014 (P = .0540) and 20 678 in 2015 to 20 832 in 2017 (P = .8509). The proportion of infants identified annually increased overall from 48.1% to 52.6% (P = .0983). The proportion of case-managed infants receiving postexposure prophylaxis, at least 3 vaccine doses, and PVST increased overall from 94.7% to 97.0% (P = .0952), 83.1% to 84.7% (P = .5377) and 58.8% to 66.8% (P = .0002), respectively.

CONCLUSIONS: The PHBPP has achieved success in managing infants born to HBsAg-positive women and ensuring their immunity to hepatitis B. Nonetheless, strategies are needed to close gaps between the number of infants estimated and identified, increase vaccine series completion, and increase ordering of recommended PVST for all case-managed infants.