Hepatitis B (perinatal transmission) Treatment in Indore

What is Hepatitis B?

Hepatitis B refers to a viral infection caused by the Hepatitis B virus, which primarily attacks the liver.

Perinatal transmission means that the virus is passed from an infected mother to her baby during pregnancy, labour, or delivery.

If not properly prevented, up to 90% of infants that are infected at birth become chronic carriers, with an increased long-term risk of liver cirrhosis and liver cancer.

Perinatal, or mother-to-child, transmission is a major route of chronic hepatitis B development worldwide.

How Perinatal Transmission Occurs

HBV can be transmitted from a pregnant individual to their newborn through:

Exposure to infected blood and bodily fluids during birth

Less commonly: via the placenta during pregnancy

Rarely through breastfeeding (safe if infant receives appropriate immunoprophylaxis)

The risk of transmission is much greater if the mother has:

High viral load

HBeAg-positive status

Acute infection in late pregnancy

Symptoms of Hepatitis B in Newborns

Infants who are infected at birth usually appear normal and are asymptomatic.

Possible Symptoms (Early, Less Common in Newborns)

Jaundice (yellowing of eyes/skin)

Poor feeding

Irritability

Pale-colored stools or dark-colored urine

Hepatomegaly

Typical Course

Infants are typically asymptomatic, but

There is a very high risk of chronic infection developing.

Chronic hepatitis B in childhood is often silent until liver disease develops years later.

Long-Term Risks for Infected Infants

If perinatal infection does occur and is not prevented:

Chronic hepatitis B

Liver inflammation

Liver fibrosis or cirrhosis

Increased risk of liver cancer (hepatocellular carcinoma)

This is why prevention immediately after birth is crucial.

Prevention of Perinatal Hepatitis B Transmission

It is highly effective if the proper steps for prevention are followed.

1. Maternal Screening During Pregnancy

All pregnant individuals should be tested for hepatitis B (by HBsAg testing).

The early identification enables proper planning for delivery and newborn care.

2. Hepatitis B Vaccine for Infants (Birth Dose)

All newborns should receive the Hepatitis B vaccine within 24 hours of birth, regardless of maternal status.

For infants of mothers with Hepatitis B:

This vaccine is the first step toward preventing infection.

It stimulates the baby's immune system to fight the virus.

3. Hepatitis B Immune Globulin (HBIG)

Infants born to HBsAg-positive mothers should receive HBIG + birth-dose vaccine within 12 hours of birth.

This combination provides:

Passive immunisation (HBIG)

Long-term immunity (vaccine)

Together, they are over 90–95% effective in preventing infection.

4. Vaccine Series Completion

The full Hepatitis B vaccination series should be completed on schedule by the infant for long-term protection.

5. Maternal Antiviral Therapy During Pregnancy

Some pregnant individuals with high viral loads may be prescribed antiviral medication by a clinician during later pregnancy as a means of decreasing the risk of transmission.

6. Post-Vaccination Serologic Testing (PVST)

Infants born to infected mothers should be tested after completing the vaccine series to confirm:

They are protected (immune)

They are not infected.

7. Breastfeeding

Mothers infected with Hepatitis B can safely breast-feed provided:

The baby is given HBIG and the birth-dose vaccine

Nipples are not cracked or bleeding

Hepatitis B is not transmitted by breastfeeding.

Key Points to Remember

Hepatitis B is passed to the baby from its mother during birth.

Newborns usually have no symptoms but are at high risk for chronic infection.

Prevention of HBV is very effective if birth-dose vaccination and HBIG are administered within 12 hours. Maternal screening and adequate newborn care are very important. Completion of the vaccine series provides lifelong protection.