Abstract
Infants born to mothers acutely or chronically ill with the Hepatitis B Virus (HBV) are at high risk of becoming chronically infected with HBV. The prevalence of HBV infection is loweramong neonates born to asymptomatic carriers of surface antigea (HBsAg) than among those whose mothers have clinical hepatitis. However clinically apparent hepatitis is more common in the former group of infants. A 32 year old female was determined to be a carrier for HBsAg at the death of her first child from fulminant Hepatitis B at 3 months of age. Her HBsAg sub type was ‘ay’ and her serum was ‘e’ antigen negative. Her second baby, born November 1976, had an uneventful postnatal course. The baby was treated with 5 ml. of HBIG titer 1:500,000 (Cutter Laboratories) on day one and every six weeks for six months. High dose multi injection therapy was given because of failure of single low dose therapy to prevent chronic antigenemia in two previous patients.Liver function tests, HBsAg and antibody to HBsAg have been followed at 3-6 weeks intervals. At eight months of age, growth and development and liver function tests are normal and HBsAg has remained negative. This case has stimulated us to screen for HBsAg in a high risk antenatal clinic. A multi-institutional study involving antenatal screening for HBsAg and treatment with HBIG is needed to determine if the chronic carrier state and neonatal Hepatitis B can be prevented.
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