HBV Infection Challenges
Approximately half of the expected births to hepatitis B surface antigen (HBsAg)-positive women are identified, indicating not all HBsAg-positive pregnant women are identified and subsequently reported to perinatal hepatitis B coordinators at health departments. An important reason for under-identification of HBsAg-positive pregnant people is that test results may not include information identifying the person with an HBsAg-positive test as pregnant.
Providers or patients might believe women known to be chronically infected with HBV do not need to be tested during pregnancy. In addition, women with Medicaid and those residing in the northeastern United States have lower screening rates. However, testing during every pregnancy helps to ensure infants are identified for postexposure management. HBsAg-positive pregnant women should receive HBV DNA testing at 26-28 weeks if not on treatment.
Antiviral therapy during pregnancy for HBsAg-positive women is recommended by the American Association for the Study of Liver Diseases. This recommendation was based on published evidence revealing that maternal antiviral therapy during pregnancy further reduces perinatal HBV transmission.