Our team assists with new WHO guidelines for treatment of hepatitis B -- read more here

Preventing Mother to Child Transmission

Picture8The Hepatitis B Foundation is dedicated to the elimination of mother-to-child transmission of hepatitis B. Globally, mother-to-child transmission is the most common route of transmission. The World Health Organization has developed guidelines to reduce transmission by improving access to testing during pregnancy services or antenatal care, improving access to birth dose within the first 24 hours of delivery for the infant, improving coverage of the pentavalent vaccination for all infants globally, and administering treatment for those infected with hepatitis B during pregnancy (with certain viral levels or if hepatitis B e antigen positive).

The Hepatitis B Foundation works with partners globally to advocate for testing access and comprehensive birth dose access for all infants. The Foundation has worked to implement programs in China, Vietnam, Uganda and Nigeria to reduce transmission of hepatitis B. Within each of these programs we have created tools and resources that might be helpful to you. We welcome you to download, read and use these tools in your communities. Do not hesitate to contact us if you want to discuss perinatal prevention or need technical assistance in your programming.

PMTCT Work in China

The Foundation’s citywide Hepatitis B Awareness Campaign in Haimen City was the first of its kind in China and was started in 2011. The campaign included educating the entire city’s population of 1.1 million people, all of the physicians and schools nurses, and most of the elected officials and community leaders. During one 12-month period, all pregnant women were screened for hepatitis B, and all newborns of infected women received the hepatitis B vaccine and HBIG to prevent a chronic infection.

photo and icons3In addition, 12,000 people were screened for hepatitis B over three months, and 1,800 (15%) tested positive for hepatitis B. Most of these patients enrolled in the HBF’s Patient Empowerment Program, which provides educational materials and strategies to empower patients to take control of their health care and to partner with their physicians to avoid the long-term complications associated with hepatitis B. This program is funded by the Bristol-Myers Squibb Foundation and Haimen City Center for Disease Control. As we look to the future, we are sharing the lessons learned, best practices developed and strategies for building coalitions through peer-reviewed publications and presentations at professional conferences.

Haimen City Publications

(2016) Cohen, C, Evans AA, Huang P, London WT, Block JM, Chen G. Hepatitis B knowledge among key stakeholders in Haimen City, China: Implications for addressing chronic HBV infection. (Hepatology, Medicine and Policy)
(2015) Evans AA, Cohen C, Huang P, Qian L, London WT, Block JM, Chen G. Prevention of perinatal hepatitis B transmission in Haimen City, China: Results of a community public health initiative. (Vaccine)
(2014) Chen G, Block JM, Evans AA, Huang P, Cohen C. Gateway to Care campaign: a public health initiative to reduce the burden of hepatitis B in Haimen City, China. (BMC Public Health)


PMTCT Work in Nigeria

Picture7Literature from Nigeria though limited demonstrates an inadequate emphasis on timely HepB-BD administration. To better understand the uptake of HepB-BD and improve its use, the Hepatitis B Foundation and partners (U.S. Centers for Disease Control and Prevention, Nigeria Centers for Disease Control and Prevention, Nigeria Ministry of Health and African Field Epidemiology Network) aimed 1) to identify barriers and facilitators for implementing the HepB-BD for children born to pregnant women participating in antenatal care in the Adamawa and Enugu states of Nigeria, 2) to evaluate the impact of provider-based training for health care professionals involved in labor and delivery and routine immunization related to hepatitis B and the importance of timely HepB-BD administration and 3) to disseminate study findings, including lessons learned, methods, and proof of concept to work towards expanding this program and improving the timely administration of HepB-BD beyond the context of this study.

Findings from the qualitative analysis demonstrate major barriers to lack of knowledge of HBV among healthcare workers, misconceptions related to vaccination contraindications, the low knowledge of the implications of the timeliness of HepB-BD administration, and vaccination wastage concerns. For pregnant women, there was low knowledge overall of hepatitis B disease but wiliness to take vaccination if it was recommended by healthcare workers. After confirming these significant knowledge gaps, training for healthcare workers was designed to emphasize the importance of timely HepB-BD. To assess uptake of timely HepB-BD vaccination administration change before and after the intervention a generalized linear mixed model was performed. Results show the rate of timely HepB-BD administration grew by 90% more in the intervention group compared to the control group over selected time points during the intervention and adjusting for the state. The intervention package and resources provided to pregnant women during ANC improved the uptake of timely HepB-BD after the intervention. To sustain improvements, the Nigerian government should continue to support capacity building of healthcare staff, generate vaccine demand by educating communities on the importance of routine immunization, and support outreach immunization services targeting hard-to-reach communities. This work was presented at the Conference on Liver Disease in Africa in 2022 (Hepatitis B Birth Dose Assessment in Nigeria) and in 2023 as an oral presentation demonstration of the efficacy the package of interventions. Endline assessment papers are currently under review.

Picture6Citations from Nigeria

Freeland C, Kanu F, Mohammed Y, Nwokoro UU, Sandhu H, et al. (2023) Barriers and facilitators to hepatitis B birth dose vaccination: Perspectives from healthcare providers and pregnant women accessing antenatal care in Nigeria. PLOS Global Public Health 3(6): e0001332. https://doi.org/10.1371/journal.pgph.0001332
Freeland, Catherine, "Strategies for Improving Hepatitis B Birth Dose in Nigeria" (2023). ProQuest ETD Collection - Thomas Jefferson University. AAI30425011.

Resources (click on the following links)

PMTCT Work in Vietnam

photo and icons 1Based on the model of success the HBF has developed in Haimen City, China, the Hepatitis B Foundation advised and provide seed money to the Vietnam Viral Hepatitis Alliance to address the enormous burden of hepatitis B. Vietnam is in Southeast Asia, where chronic hepatitis B infections are estimated to range between 8-25% of the population. Ho Chi Minh City (formerly known as ‘Saigon’) is located in South 

Vietnam and has a population of approximately 10 million people. It is the site of an ambitious multi-year public health campaign around hepatitis B that is supported by the local government and public health officials in the city. The official launch of this international initiative was on World Hepatitis Day – July 28, 2016. Since 2016, this project has documented the social determinants of health associated with hepatitis B infection; conducted education for thousands of community members and provided, screened over 10,000 people and linked individuals with care, created an advocacy program to improve the care cascade, and implemented universal implementation of PCMCT in all health systems in Ho Chi Minh City. The education, screening, advocacy and PCMCT programs were based in part on HBF programs, and HBF still serves as advisor to for this program.  


Pham, T..N. D., Mize, G.W., Do, A., Nguyen,T., Ngo., N.M., Lee, W.M, Gish, R. G., Le. A.N., Trang, A., McAdams, R., Pham, H.T., Nguyen, B.T., Tang, H.K. Tang,* and Dao, D.Y. * (*Equal Contribution). Opportunities to Establish Universal Policy to Protect Healthcare Professionals from HBV-HCV in Ho Chi Minh City, Vietnam. Hepatology. October 2018. Supplement. Abstract 2111. 
4- Tang, H.K., Pham, T., Phan, H., Nguyen, B.T., Dao, D. Hepatitis B-C screening & Access to care program in Ho Chi Minh City-A Case Management Pilot Program. Second Annual Scientific Conference, “Joint Action Towards
Elimination of Viral Hepatitis in Vietnam: Focus on Special Populations” July 29-30, 2017. Conference Center, 272, Vo Thi Sau, District 3, Ho Chi Minh City, Vietnam. Abstract 1.
5- Phan, L., Nguyen, T., Dao, D., Pham, T. Hepatitis B-C screening & Access to Care Program in Ho Chi Minh City-A survey of participants’ responses. Second Annual Scientific Conference, “Joint Action Towards Elimination of Viral Hepatitis in Vietnam: Focus on Special Populations” July 29-30, 2017. Conference Center, 272, Vo Thi Sau, District 3, Ho Chi Minh City, Vietnam. Abstract 2.