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Perinatal Hepatitis B Prevention Program

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Up to 25% of infants infected during the ... How to prevent perinatal HepB transmission ... Provide prophylaxis for infant born to HBsAg-positive women. ... – PowerPoint PPT presentation

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Title: Perinatal Hepatitis B Prevention Program


1
Perinatal Hepatitis B Prevention Program
  • Overview and Goals
  • Julie Anderson, BSN, RN
  • Perinatal Hepatitis B Presentation
  • Brazos County Health Department

2
Six Responsibilities of Perinatal Hepatitis B
Prevention Program
Assure identification of ALL HBsAg positive women
and their infants
Assure all exposed infants receive HBIG and 1st
dose of hep. B vaccine w/in 12 hours of birth
Prevention ofPerinatal Hepatitis B Transmiss
ion

Assurecompletion of 3 doses of hepatitis B
vaccine and post vaccination testing of exposed
infants
Assure that all susceptible household and sexual
contacts are vaccinated
Conduct active surveillance, quality assurance,
and outreach to improve program
3
Hepatitis B Virus
  • Caused by a double-stranded DNA virus Incubation
    period of 45-160 days
  • Can survive 30 days on surfaces
  • Causes acute and chronic HBV infection
  • Humans are the only host

4
Serologic Markers of Hepatitis B
  • There are three well defined antigens associated
    with Hep B
  • HBcAg
  • HBeAg
  • HBsAg viral antigen measured most routinely in
    blood. It is the earliest serologic marker to
    appear before onset of infection.

5
Perinatal Transmission
  • If the mother is positive for hepatitis B surface
    antigen (HBsAg) and HbeAg, the risk of perinatal
    transmission is 70-90.

6
Perinatal Transmission
  • Up to 25 of infants infected during the
    perinatal period will die in adulthood of chronic
    liver disease.

7
How to prevent perinatal HepB transmission
  • Identify HBsAg-positive pregnant women through
    serologic screening.
  • Provide prophylaxis for infant born to
    HBsAg-positive women.
  • Provide the birth dose of hepatitis B vaccine to
    ALL infants.

8
Screening Pregnant Women
  • Texas Law requires all pregnant women be screened
    for HBsAg during an early prenatal visit and at
    the time of delivery for each pregnancy.
  • (Texas Administrative Code Title 25, Part 1
    Chapter 97, subchapter F 97.135)

9
Hospital Responsibility
  • Screen all pregnant women for HBsAg at delivery
    for each pregnancy
  • Report all HBsAg-positive women to the Brazos
    County Health Department or Texas Department of
    State Health Services (DSHS).
  • Administer the hepatitis B vaccine at birth ALL
    newborns.

10
Hospital Responsibility
  • Administer the Hep B vaccine birth dose and HBIG
    within 12 hours of birth to infants born to
  • HBsAg-positive mothers
  • Mothers of unknown HBsAg status
  • Administer the Hep B vaccine birth dose to ALL
    newborns before hospital discharge.

11
Hospitals Prophylaxis of Premature Infants
  • HBsAg positive women or unknown HBV status
  • Initiate prophylaxis at birth
  • If birth weight vaccine is not counted
  • Infant will need 4 doses of Hep B vaccine
  • Initiate second dose of hepatitis B vaccine at 1
    month of age (chronological)
  • HBsAg-negative women
  • Delay first dose of Hep B vaccine until one
    month of age (chronological).

12
Recommendations
  • Document maternal HBsAg in both maternal and
    infant records.
  • Include a hard copy of HBsAg lab results in
    hospital records.
  • Establish a specific written policy for perinatal
    hepatitis B prevention.
  • Establish universal hepatitis B vaccine birth
    dose policy.

13
Reporting
  • Once HBsAg positive lab results are reported we
    provide
  • Educational and consultative services
  • Provide completion of the hepatitis B vaccine
    series.
  • Provides post-vaccination testing.
  • Provides vaccination of household and sexual
    contacts of HBsAg-positive women.

14
Prevention Outcome
  • Increase life expectancy
  • Increases quality of life
  • Reduced health care cost
  • Hepatitis B vaccine series cost 27.00
  • New liver costs1,000,000

15
How Are We Doing?
  • Only 64 of pregnant women were screened for
    HBsAg in the hospital at the time of delivery.
  • (statistic based on quality assurance review of
    the top 66 birthing hospitals in Texas)

16
Reporting Forms
  • Reporting forms are available at
  • http//www.TexasPerinatalHepB.org
  • http//www.brazoshealth.org

17
Summary
  • The overall goal of our program is twofold
    identify the pregnant women who are hepatitis B
    surface antigen positive and to prophylax their
    infants appropriately.

18
Contact Information
  • Brazos County Health Department
  • Perinatal Hepatitis B Prevention Program
  • 201 North Texas Avenue
  • Bryan, Texas 77803
  • Phone 979 -361-4440
  • Fax 979-823-2275
  • www.brazoshealth.org
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