159166 Management of hepatitis B in pregnant women: Implications for API women

Monday, November 5, 2007

Kejia Wan, MPH , Saul Krugman Division of Pediatric Infectious Diseases, Department of Pediatrics, New York University School of Medicine, New York, NY
Thomas Miyoshi, MSW , Department of Pediatrics, New York University School of Medicine, New York, NY
Neetu Sodhi, MPH , Saul Krugman Division of Pediatric Infectious Diseases, Department of Pediatrics, New York University School of Medicine, New York, NY
Jenny Bute , Saul Krugman Division of Pediatric Infectious Diseases, Department of Pediatrics, New York University School of Medicine, New York, NY
Rona Luo , Saul Krugman Division of Pediatric Infectious Diseases, Department of Pediatrics, New York University School of Medicine, New York, NY
Paige Baker , Saul Krugman Division of Pediatric Infectious Diseases, Department of Pediatrics, New York University School of Medicine, New York, NY
Sindy Yiu , Saul Krugman Division of Pediatric Infectious Diseases, Department of Pediatrics, New York University School of Medicine, New York, NY
Chia-Hui Peng, MPH , Saul Krugman Division of Pediatric Infectious Diseases, Department of Pediatrics, New York University School of Medicine, New York, NY
George Fryer, PhD , Department of Pediatrics, New York University School of Medicine, New York, NY
Henry Pollack, MD , Saul Krugman Division of Pediatric Infectious Diseases, Department of Pediatrics, New York University School of Medicine, New York, NY
Background: Although New York State mandates HBsAg testing of all pregnant women during prenatal care in order to prevent mother-infant-transmission, little is known about the management of hepatitis B infection in this population. Objectives: To assess how HBV infection is managed in pregnancy. Methods: A retrospective review of all HBsAg+ women who received care in Prenatal Clinics at Bellevue and Gouveneur Hospitals in NYC between 2004-2006. Results: Out of 6417 pregnant women tested for HBsAg, 294(4.6%) were identified HBsAg+. Mean age was 26.6±4.9 years. >60% were APIs. Among them, 271 (92.2%) had ALT tested, and 263 (89.5%) had HBeAg tested. Only 13 (11.3%) of those with HBeAg- and 18 (12.6%) of those with HBeAg+ had HBV DNA evaluated by prenatal care providers. The evaluations showed that 95% had active viral replication, with 40% had viral load>10e5 copies/ml. Conclusion: The diagnosis of hepatitis B among pregnant women is an opportune time to provide evaluations for their risks and needs for treatment. Unfortunately, this did not occur in the majority of women in this study. Persons with active infection are prone to serious long-term consequences if left unmonitored or untreated. This is particularly a concern among API which account for 60% of the HBV-infected pregnant women. Recommendations for follow-up evaluation tests of women identified by prenatal HBV screening would be of tremendous benefits for this vulnerable population.

Learning Objectives:
Recognize that the diagnosis of hepatitis B among pregnant women by State-mandated prenatal HBV screening is an opportune time to provide follow up evaluation tests.

Keywords: Hepatitis B, Prenatal Care

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

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