Maternal Hepatitis B & C Carrier State

There are an estimated 200 million chronic carriers of hepatitis B virus worldwide. Among these people there is an increased incidence of chronic active hepatitis, cirrhosis, and hepatocellular carcinoma. The frequency of the hepatitis B carrier state varies from 1% in the United States and Western Europe to 35% in parts of Africa and Asia. All pregnant women should be screened for hepatitis B surface antigen (HBsAg). Transmission of the virus to the baby after delivery is likely if both surface antigen and e antigen are positive. Vertical transmission can be blocked by the immediate postdelivery administration to the newborn of 0.5 mL of hepatitis B immunoglobulin and hepatitis B vaccine intramuscularly. The vaccine dose is repeated at 1 and 6 months of age.

Hepatitis C virus infection is the most common chronic blood-borne infection in the United States. Risk factors for transmission include blood transfusion, injecting drug use, employment in patient care or clinical laboratory work, exposure to a sex partner or household member who has had a history of hepatitis, exposure to multiple sex partners, and low socioeconomic level. The average rate of HCV infection among infants born to HCV-positive, HIV-negative women is 5-6%. However, the average infection rate increases to 14% when mothers are coinfected with HCV and HIV. The principal factor associated with transmission is the presence of HCV RNA in the mother at the time of birth.

Roberts EA: Maternal-infant transmission of hepatitis C virus infection. Hepatology 2002;36(5 Suppl 1):S106.