Dusheiko, G; (2018) A Shift in Thinking to Reduce Mother-to-Infant Transmission of Hepatitis B. [Editorial comment]. New England Journal of Medicine , 378 (10) pp. 952-953. 10.1056/NEJMe1801662.

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Abstract

The morbidity and mortality that are associated with hepatitis B virus (HBV) infection have been overshadowed by the public health prominence of other infectious diseases, including human immunodeficiency virus (HIV) infection, tuberculosis, and malaria. There is a dawning realization that the disease burden from HBV infection is increasing, despite the existence of an effective vaccine.1 The World Health Organization (WHO) estimates that chronic HBV infection results in a quarter million deaths each year in the countries that are eligible for Global Vaccine Alliance (GAVI) support or cofinancing.2 A positive status for hepatitis B e antigen (HBeAg) and a maternal HBV DNA level of more than 200,000 IU per milliliter are associated with an increased risk of perinatal HBV infection despite vaccination.3 Infection in the neonatal period and childhood remains the leading source of new chronic infections and is a silent precursor to progressive disease. Thus, the prevention of neonatal and childhood infection by effective prophylaxis is crucial.

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