Audit of linkage to care and administration of immunoprophylaxis to infants born to mothers with chronic hepatitis B infection at Monash Health 2014–2022

Background

The prevention of mother-to-child transmission of hepatitis B virus (HBV) is essential to achieve the World Health Organization's goal of eliminating HBV as a public health threat by 2030. This study examines the management of HBV in pregnant women and newborns at a large tertiary health service in Victoria, Australia.

Aims

To evaluate the timely administration of hepatitis B immune globulin (HBIG) and the birth dose vaccine to infants born to mothers with chronic hepatitis B (CHB) and to assess maternal referral to specialist care, viral load (VL) testing and antiviral therapy.

Methods

This retrospective study reviewed medical records of women with CHB who delivered at Monash Health from 2014 to 2022. Data were extracted on maternal referral to specialist care, VL testing, antiviral use and administration timing of HBIG (within 12 h) and hepatitis B vaccine (within 24 h) to newborns.

Results

Of the 895 infants, 99.7% received both HBIG and the birth dose vaccine; 97.4% received the vaccine within 12 h, and 88.3% received HBIG within the recommended 12-h window. Maternal referral rates to specialist care were 83.1%, with 91.06% undergoing VL testing during pregnancy. Antiviral therapy was administered to 16% of women.

Conclusions

High uptake of HBV immunoprophylaxis was observed, with most infants receiving timely vaccination and HBIG. However, variability exists in maternal referral and antiviral treatment. Continued efforts are needed to improve comprehensive care and reduce transmission risk across diverse settings.