Overview of HIV, Viral Hepatitis, STD, & TB During Pregnancy
Infections with HIV, viral hepatitis, STIs, and TB can complicate pregnancy and may have serious consequences for a woman, her pregnancy outcomes, and her baby.
Screening leads to access to treatment and care that can prevent perinatal transmission.
To protect all women and infants, CDC recommends the following:
Hepatitis B Virus Infection (HBV)
All pregnant women should be tested for hepatitis B surface antigen (HBsAg) during each pregnancy and those testing positive should be tested for HBV DNA. Women with HBV DNA >200,000 IU/mL should receive antiviral therapy to prevent perinatal transmission. If a pregnant woman is infected, hepatitis B virus transmission to her infant can be prevented by providing HBIG (hepatitis B immune globulin) and hepatitis B vaccine (in separate limbs) to the infant within 12 hours after birth, followed by the completion of the 3-dose vaccine series.
Hepatitis C Virus Infection (HCV)
All pregnant women should be tested for hepatitis C during each pregnancy. While there is no treatment available to prevent transmission of HCV infection from mother to child, screening for HCV infection during pregnancy allows health care providers to identify infected persons who should receive treatment during the postpartum period and infants who should receive testing during a pediatric visit. Identification of HCV infection during pregnancy also can inform pregnancy and delivery management issues that might reduce the risk of HCV transmission to the infant.
All pregnant women should be tested for HIV as early as possible, preferably at the first prenatal visit. The earlier HIV is diagnosed and treated, the more effective HIV medicines — called antiretroviral therapy or ART — can be at preventing transmission and improving the health outcomes of both mother and child.
All pregnant women should be tested for syphilis at the first prenatal visit, ideally during the first trimester of pregnancy. Among people who may be less likely to receive prenatal care, consider testing at the time of pregnancy testing. The earlier syphilis is diagnosed and treated during pregnancy, the more likely congenital syphilis and its complications (such as stillbirth) can be prevented in the infant. Penicillin G is effective for preventing maternal transmission to the fetus, as well as treating fetal and maternal infection. Women who live in areas of high syphilis morbidity or who have personal or partner risk for syphilis should be screened again at 28 weeks and at delivery. Any pregnant woman who has a fetal death after 20 weeks’ gestation should be tested for syphilis.
Healthcare providers should assess all persons, including pregnant women, for risk factors associated with latent TB infection and TB disease. While universal testing for latent TB infection and TB disease is not recommended for pregnant women in the United States, targeted testing for those with risk factors, including people living with HIV infection, people born in high TB prevalence countries, and those who are known contacts of persons with TB disease, facilitates prompt initiation of curative treatment for those with TB disease.