Overview

WHO estimates that in 2015, 257 million people were living with chronic hepatitis B virus (HBV) infection worldwide, and that 900 000 had died from HBV infection, mostly as a result of cirrhosis or hepatocellular carcinoma. Most HBV-associated deaths among adults are secondary to infections acquired at birth or in the first five years of life. In May 2016, the World Health Assembly endorsed the Global health sector strategy on viral hepatitis, which calls for the elimination of viral hepatitis as a public health threat by 2030 (defined as a 90% reduction in incidence of new infections and a 65% reduction in mortality). Elimination of HBV infection as a public health threat requires a reduction in the prevalence of hepatitis B surface antigen (HBsAg) to below 0.1% in children 5 years of age. This can be achieved through universal immunization of newborns against hepatitis B and other interventions to prevent mother-to-child transmission of HBV.

These guidelines provide evidence-based guidance on the use of peripartum antiviral prophylaxis in HBsAg-positive pregnant women for the prevention of mother-to-child transmission of HBV.

Related

• Policy brief: prevention of mother-to-child transmission of hepatitis B virus: guidelines on antiviral prophylaxis in pregnancy
• Web Annex A. Systematic review of the efficacy and safety of antiviral therapy during pregnancy - PDF, 13 MB
• Web Annex B: Systematic review of the performance of hepatitis B e antigen test, as an alternative to HBV DNA, to assess eligibility for initiating antiviral therapy during pregnancy - PDF, 4.28 MB
• Web Annex C: Impact and cost–effectiveness of HBV peripartum antiviral therapy - PDF, 1.2 MB
• Annex D. Acceptability, feasibility, values and preferences of antiviral prophylaxis for HBV-infected pregnant women in addition to timely birth dose vaccination - PDF, 420 KB
• Annex E. Framework for regional verification of the global control goal for hepatitis B surface antigen prevalence in children by 2020 - PDF, 550 KB
• Web Annex F. Summary of declared interests of Guideline Development Group members - PDF, 316 KB