Prevention Of Mother-To-Child Transmission Of Hepatitis B Virus: Guidelines On Antiviral Prophylaxis In Pregnancy (WHO Recommendation)

A) All pregnant women should be tested for HIV, syphilis and hepatitis B surface antigen (HBsAg) at least once and as early as possible in the pregnancy.

B) WHO recommends that pregnant women testing positive for HBV infection (HBsAg positive) with an HBV DNA ≥ 5.3 log10 IU/mL (≥ 200,000 IU/mL)1 receive tenofovir prophylaxis from the 28th week of pregnancy until at least birth, to prevent mother-to-child transmission of HBV. This is in addition to three-dose hepatitis B vaccination in all infants, including timely birth dose.

C) WHO recommends that in settings in which antenatal HBV DNA testing is not available, HBeAg testing can be used as an alternative to HBV DNA testing to determine eligibility for tenofovir prophylaxis to prevent mother-to-child transmission of HBV2.

D) All infants should receive their first dose of hepatitis B vaccine as soon as possible after birth, preferably within 24 hours;

E) Delivery of hepatitis B vaccine within 24 hours of birth should be a performance indicator for all immunization programmes, and reporting and monitoring systems should be strengthened to improve the quality of data on the birth dose;

F) The birth dose should be followed by two or three doses to complete the primary series.