Eliminating mother-to-child transmission of hepatitis B virus: practice and progress in Baoan, a national pilot district of China

• Published in: BMC public health Vol. 24; no. 1; p. 58
• Main Authors: Luo, Ya-Li, Gao, Shuang, Zhang, Quan-Fu, Liu, Xian, Lv, Ding-Yan, Chen, Jia-Hong, Wang, Wei
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 02.01.2024; BioMed Central; BMC
• Subjects: Analysis; Antibodies; Antigen-presenting cells; Antigens; Antiviral agents; Antiviral drugs; Antiviral therapy; Births; Children & youth; China - epidemiology; Community health care; Demographic aspects; Disease transmission; Distribution; Elimination of mother-to-child transmission; Female; Health aspects; Health services; Hepatitis; Hepatitis B; Hepatitis B - diagnosis; Hepatitis B - epidemiology; Hepatitis B - prevention & control; Hepatitis B e antigen; Hepatitis B e Antigens; Hepatitis B Surface Antigens; Hepatitis B vaccine; Hepatitis B Vaccines - therapeutic use; Hepatitis B virus; HIV; Human immunodeficiency virus; Humans; Immunization; Immunoprophylaxis; Infant; Infants; Infection; Infections; Infectious Disease Transmission, Vertical - prevention & control; Intervention; Liver; Low level; Maternal-fetal exchange; Midwifery; Newborn babies; Post-vaccination serological testing; Pregnancy; Pregnancy Complications, Infectious - drug therapy; Pregnancy Complications, Infectious - epidemiology; Pregnancy Complications, Infectious - prevention & control; Pregnant women; Prevention; Public awareness; Public health; Registration; Regression analysis; Regression models; Risk analysis; Risk factors; Risk groups; Screening; Serology; Service centers; Sexually transmitted diseases; Statistical analysis; STD; Syphilis; Telbivudine; Vaccination; Vaccines; Womens health; China; Post-vaccination serological testing; Screening; Elimination of mother-to-child transmission; Antiviral therapy; Hepatitis B virus
• ISSN: 1471-2458; 1471-2458
• DOI: 10.1186/s12889-023-17500-y

While mother-to-child transmission (MTCT) of hepatitis B virus (HBV) remains a significant challenge in China, research investigating the effectiveness of the September 2017 pilot program to eliminate MTCT of HIV, syphilis, and HBV is limited. Baoan district, which has a higher-than-average rate of hepatitis B infection among pregnant women and strong support from the government, was one of six national pilot districts selected for the program. Therefore, this study aims to assess the progress and implementation of the elimination of MTCT of HBV in Baoan district over a period of 5 years. Data was collected from the national information system for the prevention of MTCT, registration forms, and follow-up forms of pregnant women and their live births from 2018 to 2022. Joinpoint models were used to analyze changing trends over time, calculating annual percentage change (APC) and the corresponding 95% confidence interval (95%CI). Multivariate logistic regression models were used to analyze risk factors for HBV MTCT. From 2018 to 2022, the coverage of HBV screening during pregnancy increased from 98.29 to 99.55% (APC = 0.30, P = 0.012). The coverage of HBV early screening within 13 gestational weeks increased from 40.76 to 86.42% (APC = 18.88, P = 0.033). The prevalence of maternal HBV infection declined by an APC of - 3.50 (95% CI -6.28 ~ - 0.63). The coverage of antiviral therapy among high-risk pregnant women increased from 63.59 to 90.04% (APC = 11.90, P = 0.031). Coverage for timely administration of hepatitis B immunoglobulin, hepatitis B birth dose vaccine, and three-dose hepatitis B vaccination remained consistently above 97.50%. The coverage of post-vaccination serological testing (PVST) in high-risk infants was 56.15% (1352/2408), and the MTCT rate of HBV was 0.18%. Mothers with high-school education or below (OR = 3.76, 95% CI 1.04 ~ 13.60, P = 0.04) and hepatitis B e antigen (HBeAg) positivity (OR = 18.89, 95% CI 1.98 ~ 18.50, P = 0.01) had increased MTCT risk. The implementation of comprehensive prevention strategies in Baoan district, including screening, treatment, and immunoprophylaxis, has proven effective in maintaining the MTCT of HBV at an extremely low level. However, it remains crucial to raise public awareness, specifically on the importance of improving the coverage of PVST for infants exposed to HBV.