1Department of Infectious Diseases and Tropical Medicine, Leicester Royal Infirmary, Leicester LE1 5WW, UK. Electronic address: Helena.White@uhl-tr.nhs.uk.
2Department of Infectious Diseases and Tropical Medicine, Leicester Royal Infirmary, Leicester LE1 5WW, UK. Electronic address: Martin.Wiselka@uhl-tr.nhs.uk.
3Department of Paediatrics, Leicester Royal Infirmary, Leicester LE1 5WW, UK. Electronic address: Deborah.Wilson@uhl-tr.nhs.uk.
To establish the workload expected as a result of introducing antenatal antivirals for the prevention of vertical transmission of hepatitis B virus.
Retrospective review of all HBsAg-positive women and their infants, between 2005 and 2011, in a large (population 1 million) teaching NHS Trust in Leicester, UK, a highly ethnically diverse city.
7% of pregnancies occurred in women who were taking, or would now be recommended to take, antenatal antivirals. 176 infants were born to 140 HBsAg-positive women through 172 pregnancies (mean 29 pregnancies/year). Two (1.1%) were vertically infected, including one born to a mother with HBeAg-/HBeAb+ disease and HBV viral load 2 million IU/ml who would not currently be recommended for antenatal antivirals. 81.1% infants completed all HBV vaccinations; 79.5% completed serology testing. 96.4% women were referred to the hepatitis clinic, but 30% disengaged from clinic follow-up, with no significant difference between ethnic groups in terms of maternal disengagement, or failure to complete infant vaccinations or serology testing.
Only a small percentage of HBsAg-positive women are likely to meet the newly published criteria for antenatal anti-viral treatment. Strengthened community engagement across multiple ethnic groups is of paramount importance to improve maternal and infant outcomes.