Anti-HBc screening for the prevention of perinatal transmission of hepatitis B virus in France.

Abstract

As anti-HBc screening has been proposed for blood donor testing, we investigated its effectiveness during pregnancy. Among 4,023 successive pregnant women screened for anti-HBc, 539 (13.4%) were positive and further tested for HBsAg and anti-HBs. HBsAg was found in 73 (1.81%) and anti-HBc only was positive in 66 (1.64%). Among the 73 women positive for HBsAg, HBV DNA was found in the serum of seven, the cord blood of two, the placenta of three. Of the 58 infants given HBV immunoglobulins and vaccine, only four had transient HBsAg. None of the 66 women positive for anti-HBc only had anti-HBc IgM, HBeAg, or HBV DNA in serum, cord blood or placenta but five women became HBsAg positive before, at, or after delivery. Among the infants born of these 66 mothers, three had high ALT, two had HBsAg and one HBV DNA without HBsAg. Screening for anti-HBc may be cost effective, at least in low HBV prevalence areas, since there is evidence for infectivity of pregnant women positive for anti-HBc only.