Hep B Blog

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What to do about hepatitis B when you’re pregnant?

Around the world, the most common mode of hepatitis B transmission is from mother to child. Unfortunately, pregnant mothers who have hepatitis B can transmit the virus to their newborn during the delivery process. 90% of these HBV infected babies will progress to chronic infection  putting them at increased risk of serious liver disease or liver cancer later in life.

It is important that ALL pregnant women get tested for hepatitis B to prevent the transmission of the virus to newborns at birth.

The U.S. Centers for Disease Control and Prevention (CDC) recommends that all newborns born to hepatitis B positive women be given two shots in the delivery room – the first dose of hepatitis B vaccine (5 mcg dose) and one dose of hepatitis B immune globulin (HBIG, 0.5 mL dose). If a woman knows that she is infected, it is important that she tell her doctor to have these two drugs available when she is ready to deliver. These two shots must be given at separate injection sites, i.e. different limbs. When administered correctly within the first 12 hours of life, a newborn has a 95% chance of being protected against a lifelong hepatitis B infection. The infant will need to complete the hepatitis B vaccine according to schedule as part of a 3 or 4 dose series. CDC recommends follow up testing to confirm immunity or protection against HBV at 9 months or at the baby’s 1 year checkup.

The World Health Organization (WHO) recommends the birth dose of the hepatitis B vaccine for ALL babies, though it is especially important for a baby born to a woman with hepatitis B to receive the first dose of the vaccine as soon as possible, within 24 hours. HBIG may not be available in all countries or may be cost prohibitive. The hepatitis B vaccine series may be completed with the remaining monovalent  (single) injections of the HBV vaccine, or may be completed as part of a combination vaccine series.

In developing countries combination vaccines such as the pentavalent vaccine are often given to babies. The first dose of the pentavalent vaccine (which includes hepatitis B vaccine) is given at 6 weeks of age, and the 2nd and 3rd doses are given at 10 and 14 weeks of age. Waiting for the first dose at 6 weeks is too late for babies born to mothers living with chronic hepatitis, though the pentavalent vaccine should never be used as the birth dose or before 6 weeks. Women who know they have hepatitis B should talk to their doctor about ensuring that a birth dose of the hepatitis B vaccine is available for their baby at birth.

There is no second chance!  It is vitally important that we protect all newborns from hepatitis B!

Also, all infected pregnant women need to learn more about their hepatitis B infection from a liver specialist or a doctor with experience treating patients with chronic hepatitis B. It is recommended that pregnant women have their hepatitis B monitored throughout their pregnancy, to check the health of their liver and to see if they need treatment. For HBeAg positive women with high hepatitis B viral loads, taking FDA-approved antivirals during the last trimester can reduce the amount of virus in the blood and help prevent the chance of transmission to the newborn. Once an infected woman gives birth, it is important that she routinely see her doctor to keep monitoring her hepatitis B infection. Keeping mothers healthy allows them to better take care of their families!

For more information, or if you live in the U.S. and need help with hepatitis B infection during pregnancy, please visit the Perinatal Hepatitis B Prevention Program to find a coordinator near you. If you are outside of the U.S., you may consider visiting the World Hepatitis Alliance to find if there are organizations in your country that can ensure your baby starts with a birth dose of the hepatitis B vaccine.

Visit our website for additional information!

Sharing Your Story – Your Family’s Story

Sharing Your Story – Your Family’s Story

Image courtesy of Good Free Photos

Thanksgiving is not only a day to eat turkey or remind us to remember what we are thankful for; it is also National Family History Day!!1 This holiday can be used an opportunity for families to discuss and record health problems that run through the family, as this helps us live longer and healthier. 1

There are many chronic diseases that may run through multiple generations of a family. 1 Doctors can predict whether or not you could have a chronic disease just by knowing if your parents, grandparents, and other relatives have had it. 1 That is why knowing your family health history is an important and powerful screening tool.1 You can change unhealthy behaviors, reduce your risk of diseases, and know when you should be screened when you learn about what diseases run through your family. 2

Image courtesy of Wikimedia Commons

Hepatitis B is not like other chronic diseases, where if your parents have it, your genes make you more prone to it. Hepatitis B is not genetic. The hepatitis B virus is transmitted through blood and infected body fluids. This can happen through direct blood-to-blood contact, unprotected sex, body piercings or tattooing, intravenous drug use, and as a result of unsafe medical or dental procedures. It can also be transmitted from an hepatitis B positive mother to her baby at birth.

Even though hepatitis B is not genetic, you should still include it in your family health history discussion! The most common method of hepatitis B transmission worldwide is from mother-to-child due to the blood exchange that happens during child birth. Pregnant women who are infected with hepatitis B can transmit the virus to their newborns during delivery. 90% of babies exposed to hepatitis B at birth will become chronically infected with hepatitis B, which increases their risk of serious liver disease later in life. Knowing your family’s hepatitis B history can help you figure out if you and other loved ones should get screened for or vaccinated to protect against hepatitis B.

Image courtesy of Wikimedia Commons

Knowing if you have a family history of liver cancer can also be important, since hepatitis B is one of the leading causes of liver cancer. If your family has a history of hepatitis B related liver cancer, then you may have a greater risk of developing liver damage or liver cancer if you have hepatitis B. Be sure to discuss a family history of liver cancer with your liver specialist.

If you need some advice on how to start the conversation about your family health history, read more here. You can also use the US Department of Health & Human Services’s My Family Health Portrait Web tool to help start this dialogue and learn how to share family history information at a future doctor visit.

You don’t need to wait until this Thanksgiving to talk about your family health history. You can talk to your family about your family health history and hepatitis B status RIGHT NOW!


  1. https://www.hhs.gov/programs/prevention-and-wellness/family-health-history/about-family-health-history/index.html
  2. https://www.cdc.gov/genomics/famhistory/famhist_basics.htm



World Immunization Day! Hepatitis B Vaccine

While World Immunization Week takes place during April, World Immunization Day is TODAY, November 10th! The World Health Organization (WHO) established the day to raise awareness for vaccines as a cost effective and low-tech method of preventing illness and disease.

Worldwide 84% of countries have hepatitis B immunization programs; yet only 39% provide the necessary birth dose to prevent hepatitis B. This is a huge gap that must be addressed if we are to meet hepatitis elimination goals by 2030.

To celebrate World Immunization Day, here are some facts about the hepatitis B vaccine!

The safe and effective vaccine provides lifetime protection against hepatitis B, the most serious common liver infection in the world.  The vaccine is a series of 3 shots given over a 6-month period, typically at 0, 1 and 6 months.

There are minimum time periods that are needed between each dose. The second dose is given at least 4 weeks after the first dose; the third dose is given at least 8 weeks after the second dose, and there must be at least 16 weeks between doses 1 and 3.

After the 1st dose of HBV vaccine, there can be up to 50% protection. After the 2nd dose of HBV vaccine, there can be up to 80% protection.  It is very important to receive the third shot to ensure maximum, long-term protection.

If your vaccine schedule has been delayed, you do not need to start the series over, you can continue from where you have left off – even if there have been years between doses.

CDC, AAP and WHO recommend the birth dose for ALL newborns within 24 hours of birth because newborns and babies are at the greatest risk of developing lifelong, chronic infection if they are exposed to the hepatitis B virus. Giving the “birth dose” of the hepatitis B vaccine after a baby is born helps to reduce the risk of transmission to this very vulnerable population.

Perinatal prevention is especially critical for babies born to women who are infected with hepatitis B. All pregnant women should be screened for HBV. If positive, mom should be referred to care, and her baby should receive the birth dose of the vaccine and shot of hepatitis B immune globulin (HBIG), if available, within 12 hours of birth.

In order to meet this requirement, the first dose of the hepatitis B vaccine must be the “monovalent vaccine,” which means it is only the hepatitis B vaccine.

Many countries provide the “pentavalent vaccine”, which protects against 5 diseases, including hepatitis B. Unfortunately, the first dose of the “pentavalent vaccine” is given at 6 weeks, which means babies are not protected at birth and during the first 6 weeks of life against the hepatitis B virus.

It is very important that babies receive the “monovalent” hepatitis B vaccine at birth (not the “pentavalent vaccine”) in order to protect against a lifelong chronic hepatitis B infection. Babies must complete the vaccine series according to schedule. This can be done singly with the HBV monovalent vaccination or in combination with other vaccines (pentavalent, hexavalent etc.) Babies born to mothers that are hepatitis B positive should follow up with post-serologic testing at 9 months or a year to ensure the baby is protected against the hepatitis B virus.

There is no second chance to protect a newborn or baby from hepatitis B!

If a child, adolescent or adult missed the hepatitis B vaccine, they can be vaccinated at any time. For adults, it is never too late to start the hepatitis B vaccine (unless you are already infected with the hepatitis B virus, or have recovered from a past infection).

For more information on hepatitis B vaccine in babies or children, consult the “Summary of Recommendations for Child/Teen Immunization.” For more information on hepatitis B vaccine in adults, consult CDC’s Recommended Adult Immunization Schedule.

Be sure to talk to your doctor about getting the hepatitis B vaccine (if you have not already). Not only does it protect against hepatitis B, but also hepatitis D and help prevent liver cancer!



U.S. Residents Only: Reporting Discriminatory Behavior Due to Chronic HBV Infection

Unknown-1An important message from the U.S. Department of Justice (DOJ) which pertains only to U.S. Residents:

If you or someone you know is dismissed or barred from a program due to chronic hepatitis B infection, report the incident to the Department of Justice, whether the complaint is against a State or local agency, a school or any private entity that serves the public.

As a friend, advocate or colleague, you have the right to file a complaint to report discriminatory behavior.  Fill in and submit the Americans with Disabilities Act (ADA) Complaint Form (www.ada.gov/t2cmpfrm.htm).

Kindly return the form to the following address:
U.S. Department of Justice
Civil Rights Division
950 Pennsylvania Avenue, NW
Disability Rights – NYAV
Washington, D.C. 20530

Or you may print and send the report via fax to the following number: (202) 307-1197.

Please note: you must be a U.S. resident in order to file a complaint with the U.S. Department of Justice