As vertical transmission of the hepatitis B virus (HBV) from mother to child is the main transmission route for the virus in Taiwan, the Taiwan Children Liver Foundation urged mothers with HBV to have their babies vaccinated against HBV and to receive the Human Hepatitis B Immunoglobulin injection if necessary.
World Hepatitis Day will be next Sunday, the foundation said, and to promote this year’s theme “This is hepatitis. Know it. Confront it,” the foundation is to hold seven free lectures for mothers with HBV next month.
Wen Wan-hsin (文萬欣), an attending physician in pediatric gastroenterology at Cardinal Tien Hospital, said HBV infection can be acute or chronic.
“Acute cases are those who were infected, but then generated antibodies. Chronic cases involve those who remain infected, or hepatitis B surface antigen positive, for more than six months after exposure to the virus and become carriers of the virus,” Wen said.
Fifteen to 40 percent of chronically infected individuals develop chronic inflammatory liver diseases, cirrhosis of the liver or liver cancer at some point in their life and, more importantly, “90 percent of infants infected at birth suffer from chronic HBV infection,” Wen added.
The prevalence of chronic HBV infection among children and teenagers in Taiwan was once as high as 10 to 20 percent, Wen said, but the rate had decreased drastically to less than 1 percent after the implementation of universal infant hepatitis B vaccinations in 1986.
Vertical transmission from mother to child is therefore the main route of HBV infection in present-day Taiwan.
Attending physician in pediatrics at National Taiwan University Hospital Chen Huey-ling (陳慧玲) advised all pregnant women to be screened for hepatitis B surface antigen, the presence of which indicates HBV infection, and hepatitis B extracellular (HBeAg) antigen, a protein from HBV that circulates in infected blood when the virus is replicating and multiplying.
Research conducted by National Taiwan University Hospital, Cardinal Tien Hospital and Tzu Chi General Hospital has found that 80.2 percent of the HBeAg-positive mothers have high viral load, which is significantly correlated with mother-to-infant transmission, compared to the 0.5 percent of the HBeAg-negative mothers.
So if the mother is HBeAg positive, the baby is highly susceptible to HBV infection, Chen said.
“These babies will need to receive hepatitis B immunoglobulin injections within 24 hours of birth, in addition to three doses of the hepatitis B vaccine administered according to the vaccination schedule,” he added.