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Hepatitis B Guidelines for Pregnant Women: Whatever it takes.

Hepatitis B, the most common liver infection worldwide, is caused by the hepatitis B virus (HBV). The virus attacks the liver cells. It can culminate into liver failure, cirrhosis (scarring), or liver cancer (hepatocellular carcinoma) in the years that follow. It spreads through contact with infected blood and bodily fluids.

During pregnancy or delivery, pregnant women infected with hepatitis B can transmit the virus to the newborns. In the absence of any preventive measure, about 90% of such babies will become chronically infected with hepatitis B at birth. It implies all pregnant women must be tested for HBV to prevent infection.

When a pregnant woman tests positive for HBV, her newborn baby must receive two shots in the delivery room – the first dose of hepatitis B vaccine and one dose of hepatitis B immune globulin. These two medications if given correctly in 12 hours following delivery, provide a 95% probability of protection to the newborn against a lifelong HBV infection. Nonetheless, the infant will need additional doses of hepatitis B vaccine at one and six months to provide complete protection. When a pregnant woman knows that she has HBV, she should tell her health care provider in advance such that these two medications are available when delivery ensues. Any newborn baby who does not promptly receive these medications has a greater than 90% probability that he or she will become chronically infected. We have no second chance!

It is prudent that we vaccinate all newborn babies at birth against HBV!

What about breastfeeding? According to the World Health Organization, it is safe for women infected with HBV to breastfeed their children. We encourage such women to breastfeed their babies because the benefits of breastfeeding outweigh the potential risk of transmitting the virus through breast milk. This risk reduces further if all these newborns receive the hepatitis B vaccine at birth.

To know whether you are infected or not, we do a hepatitis B blood panel. It consists of three blood tests, namely; Hepatitis B Surface Antigen (HBsAg), Hepatitis B Surface Antibody (HBsAb or anti-HBs), and Hepatitis B Core Antibody (HBcAb or anti-HBc).

It is prudent that we vaccinate all newborn babies at birth against HBV!

The surface antigen is the part of the HBV that we find in the blood of an infected person. When this is positive, hepatitis is present. The human body forms the surface antibody in response to the HBV. Your body can make this antibody if you got the hepatitis B vaccine, or if you recovered from an HBV infection. When this test is positive, your immune system has successfully developed a protective antibody against the HBV. It provides long-term protection against HBV infection.

The hepatitis B core antibody does not confer any protection or immunity against the HBV. A positive test indicates the person may have got exposure to the HBV. Blood banks often use this test to screen blood donations. To note, we need all the three test results to make a diagnosis.

Related article: These medical conditions make pregnancy very risky: You should know them.

An infected father, sibling or any other family member can expose children to HBV through contact with infected blood and body fluids. We can prevent this through vaccination only.

We recommend that anyone living in a household with an infected family member should be vaccinated. It is especially important for children since the risk of developing a chronic infection if exposed to HBV at an early age is high. The vaccine is a series of three shots given over a six-month period that will provide lifetime protection. Until your vaccine series is complete, avoid sharing any sharp instruments such as razors, toothbrushes, or earrings since they can allow an exchange of small amounts of blood through them. Also, infected individuals should be careful to keep all cuts well covered. Clean all blood spills with gloves and a 10% bleach/water solution. HBV is not transmitted casually – it cannot be spread through sneezing, coughing, hugging, or eating food prepared by someone who has HBV.

The best protection for you and your loved ones is the hepatitis B vaccine. The world has used over 1 billion doses of the vaccine have to date, making it the most widely used vaccine in the world.

We’ve prepared this article using the information provided by the HBV

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MBChB (MUK), Graduate Fellow, Department of Physiology, Makerere University Founder and Content Creator Peer reviewer, Associate Editor

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