What is hepatitis B (HBV)?

Hepatitis is inflammation of the liver, resulting in liver cell damage and destruction. Five main types of the hepatitis virus have been identified. The symptoms of HBV include jaundice (yellowing of skin, eyes, and mucous membranes), fatigue, abdominal pain, loss of appetite, intermittent nausea, and vomiting. A blood test for hepatitis B is part of routine prenatal testing.

The most common type that occurs during pregnancy is hepatitis B (HBV). This type of hepatitis spreads mainly through contaminated blood and blood products, sexual contact, and contaminated intravenous (IV) needles.

Although HBV resolves in most people, about 10 percent will have chronic HBV. Hepatitis B virus can lead to chronic hepatitis, cirrhosis, liver cancer, liver failure, and death.

How does hepatitis B (HPV) affect a pregnancy?

Infected pregnant women can transmit the virus to the fetus during pregnancy and delivery. If you contract the virus during pregnancy there is a greater chance for the baby contracting the infection.

How do you test for Hepatitis B in pregnancy?

Hepatitis B infection can be diagnosed with a blood test. Different tests are available. The antigen test checks for the presence of the virus and the antibody test checks for the body's immune response to the virus.

The first test done by obstetricians is to test for the hepatitis B surface antigen. After an infection, most adults will clear the virus from the body usually after several months to a year. If the hepatitis B virus is not cleared from the body (i.e. in carriers), the surface antigen remains positive for life. Hepatitis B surface antigen is present in the blood of people who are acutely or chronically infected with hepatitis B virus. People with a positive Hepatitis B surface antigen are infectious, they are chronic carriers, and can transmit the virus. Chronic carriers are of concern as they can transmit the virus to others including the baby.

Hepatitis B core antibody is present in the blood of people who have been infected with hepatitis B in the past. It is present in carriers of hepatitis B, but also in people who have cleared the virus from their body. If the core antibody is positive and the Hepatitis B surface antigen is negative, then there is immunity to hepatitis B. These people are not carriers and there is no risk of transmitting the virus to others or developing hepatitis B-related liver complications later.

Hepatitis B surface antibody is positive in people who have been exposed to hepatitis B previously but have cleared the virus from their body. It is also usually positive in people who have been vaccinated against hepatitis B. People who test positive for surface antibody are immune to hepatitis B or are vaccinated; they are not carriers.

What is the treatment for hepatitis B?

Specific treatment for hepatitis B will be determined by your physician based on:

• your overall health and medical history
• the extent of the disease
• your tolerance for specific medications, procedures, or therapies
• expectations for the course of the disease
• your opinion or preference

HBV antigen-positive mothers may receive a drug called hepatitis B immune globulin. Infants of HBV positive mothers should receive hepatitis B immune globulin and the hepatitis B vaccine in the first 12 hours of birth. The Centers for Disease Control and Prevention (CDC) recommends all babies to complete the hepatitis B vaccine series by 6 to 18 months of age to be fully protected against hepatitis B infection.