National Hepatitis B Strategy 2010–2013

5.3 Children born to mothers with chronic hepatitis B (pregnant women)

Page last updated: July 2010

While 95 per cent of adults clear their initial hepatitis B infection, only 10 per cent of neonates and children do, meaning they have chronic hepatitis B throughout their lives and a higher lifetime risk of advanced liver disease. It is therefore crucial to promote screening of pregnant women for hepatitis B infection, as recommended in the Australian and New Zealand Chronic Hepatitis B Recommendations, to allow intervention to prevent transmission from mother to child.10 Furthermore, any woman diagnosed with chronic hepatitis B should be referred to a clinician with expertise in managing viral hepatitis during pregnancy. Recent Australian evidence suggests that transmission occurs in approximately 10 per cent of women diagnosed antenatally.11

Any child born to a mother with chronic hepatitis B should be assessed for chronic hepatitis B infection after the course of vaccination has been completed. Children diagnosed with chronic hepatitis B should be referred to a paediatric service with expertise in viral hepatitis. Although most will have minimal liver disease early in life, this is not true for all children with chronic infection.12 A recent study reported that referral of these children for assessment is rarely occurring in Australia.13

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10 Digestive Health Foundation (Gastroenterological Society of Australia), 2008, ‘Australian and New Zealand Chronic Hepatitis B Recommendations: Clinical update’, ed. 1, Digestive Health Foundation, Sydney.
11 Guirgis M, Zebry A, Yan K, Bu Yang Min & Lee A 2009, ‘Chronic hepatitis B infection in an Australian antenatal population: seroprevalence and opportunities for better outcomes’, Journal of Gastroenterology and Hepatology, vol. 24, issue 6: pp. 998–1001.
12 Bortolotti F, Calzia R, Cadrobbi P, Giacchini R, Ciravegna B, Armigliato M, Piscopo R & Realdi G ‘Liver cirrhosis associated with chronic hepatitis B virus infection in childhood’, J Pediatr, February 1986, no. 108, vol. 2, pp. 224–227. PubMed.
13 Nightingale S, O Stormon M, Day A, Webber M, Ward K & O’Loughlin E 2009, ‘Chronic hepatitis B and C infection in children in New South Wales’, Medical Journal of Australia, vol. 190 (12): pp. 670–673.