| Title | An Investigation of Perinatal Hepatitis B Virus Infections Among a High Risk Population: The Delivery Hospital as a Safety Net. | | Author(s) | Fischer G, Wang S, Ahring S, Fowler K, Hainline S, Chinglong M, Jacques-Carroll L, Bell B, Williams I | | Institution | From the *Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, GA; daggerArkansas Department of Health and Human Services, Little Rock, AK; double daggerImmunization Services Division, Centers for Disease Control and Prevention, Atlanta, GA; and section signWashington County Health Unit, Fayetteville, AK. | | Source | Pediatr Infect Dis J 2009 May 18. | | Abstract | BACKGROUND:: There was an increase in perinatal hepatitis B virus (HBV) infections in one Arkansas county that disproportionately affected Marshallese infants.
METHODS:: An estimated 6000 to 10,000 Marshallese, from the Pacific island nation of the Marshall Islands where HBV is highly endemic, live in one Arkansas county. We conducted a retrospective review of hospital and health department records from 2003 to 2005 in that county. We compared maternal screening for hepatitis B surface antigen (HBsAg) between Marshallese and non-Marshallese. We also reviewed birth and immunization records for infants born to HBsAg-positive mothers to evaluate postexposure prophylaxis (PEP).
RESULTS:: Ten percent (n = 41) of Marshallese births and 0.1% (n = 15) of non-Marshallese births were to HBsAg-positive women. Among those born to HBsAg-positive women, Marshallese and non-Marshallese infants were equally likely to receive PEP with hepatitis B vaccine (98% vs. 100%; P[r] = 0.98) and hepatitis B immune globulin (HBIG) </=12 hours after birth (88% vs. 87%; P = 0.91). Approximately 57% (n = 32) of all infants born to HBsAg-positive women were tested for perinatal HBV infection. The proportion of Marshallese (17%) and non-Marshallese (13%) infants who tested positive for HBsAg at ages 9 to 25 months was similar (P = 0.78). Receiving HBIG >12 hours after birth was the only factor significantly associated with infection.
CONCLUSIONS:: Although HBV infection was more prevalent among Marshallese compared with non-Marshallese women, there were no differences in infant receipt of PEP and perinatal HBV infection. Delivery hospitals in this county had standing orders to administer hepatitis B vaccine to all newborns, which likely provided a safety net to prevent perinatal HBV transmission in this high-risk population. | | Language | ENG | | Pub Type(s) | JOURNAL ARTICLE
| | PubMed ID | 19455073 |
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