title: Management of infants born to women infected with hepatitis B in the military healthcare system.
abstract: BACKGROUND
  Hepatitis B virus (HBV) is endemic worldwide. Given significant rates of infectivity, all infants born to Hepatitis B surface antigen positive mothers need to receive treatment at birth, immunization and post-vaccination serologic testing. However, not all infants complete these requirements.
  
  
  RESULTS
  We performed a retrospective review of the management of infants born to Hepatitis B infected mothers at two large military hospitals in the United States that use a global electronic medical record to track patient results. We then compared these results to those recently published by the National Perinatal Hepatitis B Prevention Program (PHBPP), which does not include hospitals in the United States Military Healthcare System. Our results show that although all infants were managed appropriately at birth and immunization rates were very high, post vaccination follow-up testing rates were much lower than those seen in centers participating in the PHBPP. The rates of post vaccination serological testing were significantly higher for infants born to Hepatitis B e antigen positive mothers and those referred to a pediatric infectious disease specialist.
  
  
  CONCLUSIONS
  Despite use of a global electronic medical record in the United States Military Healthcare System, management of HBV-exposed infants does not always follow recommended guidelines. These infants could benefit from a more systematic method of follow-up, similar to the PHBPP, to ensure HBV serologic testing is obtained after the vaccination series is complete.
authors.affiliation: Department of Pediatrics, Tripler Army Medical Center, Honolulu, HI 96859-5000, USA. rebecca.j.sainato.mil@mail.mil.
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Sainato
authors.forename: Elizabeth G
authors.initials: EG
authors.lastname: Simmons
authors.forename: Dawn F
authors.initials: DF
authors.lastname: Muench
authors.forename: Mark W
authors.initials: MW
authors.lastname: Burnett
authors.forename: LoRanée
authors.initials: L
authors.lastname: Braun
mesh_terms: D000328:Adult; D002648:Child; D003695:Delivery of Health Care / Q000458:organization & administration*; D057286:Electronic Health Records / Q000706:statistics & numerical data; D005260:Female; D006509:Hepatitis B / Q000276:immunology / Q000517:prevention & control* / Q000635:transmission / Q000821:virology; D006510:Hepatitis B Antibodies / Q000097:blood; D017325:Hepatitis B Vaccines / Q000008:administration & dosage / Q000276:immunology*; D006513:Hepatitis B e Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000502:physiology; D006772:Hospitals, Military; D006801:Humans; D007114:Immunization / Q000706:statistics & numerical data*; D007223:Infant; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000276:immunology / Q000517:prevention & control* / Q000821:virology; D014481:United States
chemical_list: D006510:Hepatitis B Antibodies; D017325:Hepatitis B Vaccines; D006513:Hepatitis B e Antigens