Neonatal HBV - Revision history

Aidan at 10:36, 6 December 2020

2020-12-06T10:36:32Z

← Older revision		Revision as of 10:36, 6 December 2020
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	*Transmitted perinatally during delivery (rarely transmitted in utero)		*Transmitted perinatally during delivery (rarely transmitted in utero)
	**Highest risk is with acute infection during the third trimester		**Highest risk is with acute infection during the third trimester
	*Transmission from ~~HBaAg~~-positive mothers is 30% if HBeAg-negative and 85% if HBeAg-positive		*Transmission from HBsAg-positive mothers is 30% if HBeAg-negative and 85% if HBeAg-positive

	==Clinical Manifestations==		==Clinical Manifestations==

Aidan at 15:40, 6 August 2020

2020-08-06T15:40:32Z

← Older revision		Revision as of 15:40, 6 August 2020
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	== Background ==		==Background==

	=== Epidemiology ===		===Epidemiology===

	* Transmitted perinatally during delivery (rarely transmitted in utero)		*Transmitted perinatally during delivery (rarely transmitted in utero)
			**Highest risk is with acute infection during the third trimester
	* Transmission from HBaAg-positive mothers is 30% if HBeAg-negative and 85% if HBeAg-positive		*Transmission from HBaAg-positive mothers is 30% if HBeAg-negative and 85% if HBeAg-positive

	== Clinical Manifestations ==		==Clinical Manifestations==

	* 80-90% of infected infants will develop chronic infection		*80-90% of infected infants will develop chronic infection
	* Mostly asymptomatic		*Mostly asymptomatic

	== Prevention ==		==Prevention==

	*Mother should take [[tenofovir]] starting at 28-32 weeks gestation if viral load is greater than 200,000 IU/mL, until 3 months postpartum		*Mother should take [[tenofovir]] starting at 28-32 weeks gestation if viral load is greater than 200,000 IU/mL, until 3 months postpartum
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	**HBIG can be given up to 7 days of life but is most effective when given earlier		**HBIG can be given up to 7 days of life but is most effective when given earlier
	**Vaccine and HBIG should be given in separate limbs		**Vaccine and HBIG should be given in separate limbs
	**Overall, decreases transmission from 30-85% down to 1%		**Overall, decreases transmission from 30-85% down to 1-2%
	*No need for Cesarean section to prevent transmission		*No need for Cesarean section to prevent transmission
	*Monitoring		*Monitoring
	**Completion of routine vaccination schedule		**Completion of routine vaccination schedule
	***~~The~~ ~~initial~~ ~~vaccine~~ ~~for~~ ~~infants~~ ~~with~~ ~~birth~~ ~~weight~~ <2 kg ~~does~~ not count towards their ~~schedule~~		***If the birth weight is less than 2000 g, the birth dose should not count towards their vaccine series
	**Postvaccination HBsAg serology is recommended for children born to HBsAg-positive mothers		**Postvaccination HBsAg serology is recommended for children born to HBsAg-positive mothers
	***Usually at age 9 to 12 months		***Usually at age 9 to 12 months
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	***HBsAg positive: refer for management		***HBsAg positive: refer for management
	**Even if not infected, maternal HBcAb may persist in the baby up to 24 months of age		**Even if not infected, maternal HBcAb may persist in the baby up to 24 months of age
			*Recommend breastfeeding if the infant received appropriate prophylaxis
			*Remember to screen other family members for [[Hepatitis B virus\|hepatitis B]]
	*Also see article on [[neonatal HIV]]		*Also see article on [[neonatal HIV]]

	== Further Reading ==		==Further Reading==

	* Prevention of Hepatitis B Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices. ''MMWR Recomm Rep''. 2018;67(RR-1):1-31. doi: [https://doi.org/10.15585/mmwr.rr6701a1 10.15585/mmwr.rr6701a1]		*Prevention of Hepatitis B Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices. ''MMWR Recomm Rep''. 2018;67(RR-1):1-31. doi: [https://doi.org/10.15585/mmwr.rr6701a1 10.15585/mmwr.rr6701a1]

	[[Category:Infectious diseases]]		[[Category:Infectious diseases]]

Aidan: added much more detail, from CDC recommendations

2020-08-06T15:26:33Z

added much more detail, from CDC recommendations

← Older revision		Revision as of 15:26, 6 August 2020
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			== Background ==
⚫	* If mother has hepatitis B, or her status is unknown, then consider post-exposure prophylaxis with [[hepatitis B immune globulin]] and [[hepatitis B vaccine]] given within 12 hours of life

⚫	** Vaccine prevents about 90% of infections, with HBIG adding a bit more
			=== Epidemiology ===
⚫	** HBIG can be given up to 7 days of life but is most effective when given earlier

⚫	* Also see article on [[neonatal HIV]]
			* Transmitted perinatally during delivery (rarely transmitted in utero)
			* Transmission from HBaAg-positive mothers is 30% if HBeAg-negative and 85% if HBeAg-positive

			== Clinical Manifestations ==

			* 80-90% of infected infants will develop chronic infection
			* Mostly asymptomatic

			== Prevention ==

			*Mother should take [[tenofovir]] starting at 28-32 weeks gestation if viral load is greater than 200,000 IU/mL, until 3 months postpartum
			**See also [[Hepatitis B in pregnancy#Management\|hepatitis B in pregnancy]]
		⚫	*If mother has active [[hepatitis B]] (that is, HBsAg is positive) or if her status is unknown, then consider post-exposure prophylaxis with [[hepatitis B immune globulin]] and [[hepatitis B vaccine]] given within 12 hours of life
		⚫	**Vaccine prevents about 90% of infections, with HBIG adding a bit more
		⚫	**HBIG can be given up to 7 days of life but is most effective when given earlier
			**Vaccine and HBIG should be given in separate limbs
			**Overall, decreases transmission from 30-85% down to 1%
			*No need for Cesarean section to prevent transmission
			*Monitoring
			**Completion of routine vaccination schedule
			***The initial vaccine for infants with birth weight <2 kg does not count towards their schedule
			**Postvaccination HBsAg serology is recommended for children born to HBsAg-positive mothers
			***Usually at age 9 to 12 months
			***HBsAg negative with HBsAb ≥10 mIU/mL: no further management
			***HBsAg negative with HBsAb <10 mIU/mL: give another dose of vaccine and repeat testing in 1 to 2 months
			****If still <10 mIU/mL, then give two additional doses to complete a full second series and repeat testing in 1 to 2 months
			***HBsAg positive: refer for management
			**Even if not infected, maternal HBcAb may persist in the baby up to 24 months of age
		⚫	*Also see article on [[neonatal HIV]]

			== Further Reading ==

			* Prevention of Hepatitis B Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices. ''MMWR Recomm Rep''. 2018;67(RR-1):1-31. doi: [https://doi.org/10.15585/mmwr.rr6701a1 10.15585/mmwr.rr6701a1]

	[[Category:Infectious diseases]]		[[Category:Infectious diseases]]

Aidan at 13:12, 2 August 2020

2020-08-02T13:12:01Z

← Older revision		Revision as of 13:12, 2 August 2020
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	* If mother has hepatitis B, or her status is unknown, then consider post-exposure prophylaxis with hepatitis B immune globulin and hepatitis B vaccine given within 12 hours of life		* If mother has hepatitis B, or her status is unknown, then consider post-exposure prophylaxis with [[hepatitis B immune globulin]] and [[hepatitis B vaccine]] given within 12 hours of life
	** Vaccine prevents about 90% of infections, with HBIG adding a bit more		** Vaccine prevents about 90% of infections, with HBIG adding a bit more
	** HBIG can be given up to 7 days of life but is most effective when given earlier		** HBIG can be given up to 7 days of life but is most effective when given earlier
	* Also see article on [[neonatal HIV]]		* Also see article on [[neonatal HIV]]

			[[Category:Infectious diseases]]
			[[Category:Pediatrics]]

Aidan: Created page with "* If mother has hepatitis B, or her status is unknown, then consider post-exposure prophylaxis with hepatitis B immune globulin and hepatitis B vaccine given within 12 hours o..."

2019-11-16T03:44:12Z

Created page with "* If mother has hepatitis B, or her status is unknown, then consider post-exposure prophylaxis with hepatitis B immune globulin and hepatitis B vaccine given within 12 hours o..."

New page

* If mother has hepatitis B, or her status is unknown, then consider post-exposure prophylaxis with hepatitis B immune globulin and hepatitis B vaccine given within 12 hours of life
** Vaccine prevents about 90% of infections, with HBIG adding a bit more
** HBIG can be given up to 7 days of life but is most effective when given earlier
* Also see article on [[neonatal HIV]]