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Outcomes from a Canadian Public Health Prenatal Screening Program for Hepatitis B

1997–2004

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Abstract

Background

Without appropriate prophylaxis, the rate of vertical transmission of hepatitis B virus (HBV) can be as high as 95%. Alberta’s provincial prenatal program screens all pregnant women for HBV, and provides prophylaxis to infants born to HBV-infected women. Canadian data on the outcomes of such programs are limited.

Methods

We conducted a retrospective review of data from pregnant Albertan women who were Hepatitis B Surface Antigen (HBsAg) positive from 1997–2004. We describe the frequency of hepatitis B immunoglobulin (HBIG) and vaccine administration, follow-up serology and pregnancy outcomes.

Results

In total, 1,485 HBsAg-positive pregnant women were identified; an average of 186 women annually (range: 125–216). Of the 980 infants eligible to have completed prophylaxis and serological follow-up, 82.0% were appropriately immunized and serologically tested, 11.3% had complete immunization but no serology testing and 6.6% were incompletely immunized. Of infants with complete immunization and follow-up, 3.7% failed to mount an immune response and 2.1% were infected.

Conclusion

A high proportion of infants born to carrier mothers are receiving appropriate post-natal prophylaxis in Alberta. Future research should examine maternal factors that may increase the vertical transmission of HBV.

Résumé

Contexte

Sans prophylaxie appropriée, le taux de transmission verticale du virus de l’hépatite B (VHB) peut atteindre 95 %. Dans le cadre du programme prénatal provincial de l’Alberta, toutes les femmes enceintes sont testées pour le VHB, et la prophylaxie est offerte aux nourrissons de femmes infectées par le virus. Les données canadiennes sur les résultats de tels programmes sont limitées.

Méthode

Nous avons mené une étude rétrospective auprès des femmes enceintes de l’Alberta qui étaient porteuses de l’antigène de surface de l’hépatite B (AgHBs) entre 1997 et 2004. Nous avons décrit la fréquence de l’administration de l’immunoglobuline anti-hépatite B (HBIg) et du vaccin contre le VHB, les résultats des tests sérologiques et les résultats de grossesse.

Résultats

Sur l’ensemble des femmes enceintes testées, 1 485 porteuses de l’AgHBS ont été identifiées, soit en moyenne 186 femmes par année (125 à 216). Des 980 nourrissons admissibles à la prophylaxie complète et au suivi sérologique, 82 % avaient reçu tous les vaccins ainsi que les tests sérologiques, 11,3 % avaient reçu les vaccins mais aucun test sérologique, et 6,6 % n’avaient pas été complètement immunisés. Sur les nourrissons immunisés et ayant fait l’objet d’un suivi sérologique, 3,7 % n’avaient pas manifesté de réponse immunitaire, et 2,1 % étaient infectés.

Conclusion

En Alberta, une proportion élevée de nourrissons de mères infectées par le VHB reçoit la prophylaxie postnatale appropriée. D’autres études sont nécessaires pour déterminer les facteurs maternels qui augmentent le risque de transmission du VHB de la mère à l’enfant.

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Authors and Affiliations

  1. Centre for Infectious Disease Control and Prevention, Public Health Agency of Canada, Ottawa, ON, Canada

    Sabrina S. Plitt PhD

  2. Provincial Health Office, Alberta Health and Wellness, University of Alberta, 24th Floor, Telus Plaza North Tower, PO Box 1360 Stn Main, 10025 Jasper Avenue, Edmonton, AB, T5J 2N3, Canada

    Sabrina S. Plitt PhD &  Ameeta E. Singh BMBS, MSc, FRCPC

  3. College of Medicine & KKUH, King Saud University, Riyadh, Saudi Arabia

    Ali M. Somily MD

  4. Alberta Health and Wellness, Edmonton, AB, Canada

    Ameeta E. Singh BMBS, MSc, FRCPC

Authors
  1. Sabrina S. Plitt PhD
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  2. Ali M. Somily MD
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  3. Ameeta E. Singh BMBS, MSc, FRCPC
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Correspondence to Ameeta E. Singh BMBS, MSc, FRCPC.

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Plitt, S.S., Somily, A.M. & Singh, A.E. Outcomes from a Canadian Public Health Prenatal Screening Program for Hepatitis B. Can J Public Health 98, 194–197 (2007). https://doi.org/10.1007/BF03403711

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  • DOI: https://doi.org/10.1007/BF03403711

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