The hepatitis B virus (HBV) is a DNA virus that is transmitted mainly in blood, but also in other body fluids such as saliva, semen and vaginal fluid. Drug users who share needles are at high risk. In some areas in the world, chronic hepatitis B is prevalent and vertical transmission is common.

About 2 billion people worldwide are infected with HBV. More than 350 million have chronic (lifelong) infections. The prevalence of hepatitis B surface antigen (HBsAg) in pregnant women has been found to range from 0.5 to 1 % in UK. There is wide variation in prevalence among different ethnic groups, and oriental women in particular appear to have a higher prevalence of HBsAg.

HBV is a virus that infects the liver, but many people with hepatitis B viral infection have no symptoms. The HBV has an incubation period of 6 weeks to 6 months.

Serological screening for HBV should be offered to pregnant women so that effective post-natal intervention can be offered to infected women to decrease the risk of mother-to-child transmission. As many as 85% of babies born to mothers who are positive for the hepatitis e antigen (eAg) will become HBsAg carriers and subsequently become chronic carriers, compared with 31% of babies who are born to mothers who are eAg negative. It has been estimated that chronic carriers of HBsAg are 22 times more likely to die from hepatocellular carcinoma or cirrhosis than non-carriers.

Mother-to-child transmission of the HBV is approximately 95% preventable through administration of vaccine and immunoglobulin to the baby at birth. To prevent mother-to-child transmission, all pregnant women who are carriers of HBV need to be identified. It is therefore, recommended that all pregnant women be screened for HBV. Women who screen positive for hepatitis B should be referred to a hepatologist for ongoing monitoring for the long-term consequences of chronic infection, for example hepatocellular carcinoma.

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