title: Antenatal hepatitis B in a large teaching NHS Trust - implications for future care.
abstract: OBJECTIVE
  To establish the workload expected as a result of introducing antenatal antivirals for the prevention of vertical transmission of hepatitis B virus.
  
  
  METHODS
  Retrospective review of all HBsAg-positive women and their infants, between 2005 and 2011, in a large (population 1 million) teaching NHS Trust in Leicester, UK, a highly ethnically diverse city.
  
  
  RESULTS
  7% of pregnancies occurred in women who were taking, or would now be recommended to take, antenatal antivirals. 176 infants were born to 140 HBsAg-positive women through 172 pregnancies (mean 29 pregnancies/year). Two (1.1%) were vertically infected, including one born to a mother with HBeAg(-)/HBeAb(+) disease and HBV viral load 2 million IU/ml who would not currently be recommended for antenatal antivirals. 81.1% infants completed all HBV vaccinations; 79.5% completed serology testing. 96.4% women were referred to the hepatitis clinic, but 30% disengaged from clinic follow-up, with no significant difference between ethnic groups in terms of maternal disengagement, or failure to complete infant vaccinations or serology testing.
  
  
  CONCLUSIONS
  Only a small percentage of HBsAg-positive women are likely to meet the newly published criteria for antenatal anti-viral treatment. Strengthened community engagement across multiple ethnic groups is of paramount importance to improve maternal and infant outcomes.
authors.affiliation: Department of Infectious Diseases and Tropical Medicine, Leicester Royal Infirmary, Leicester LE1 5WW, UK. Electronic address: Helena.White@uhl-tr.nhs.uk.
authors.forename: H A
authors.initials: HA
authors.lastname: White
authors.affiliation: Department of Infectious Diseases and Tropical Medicine, Leicester Royal Infirmary, Leicester LE1 5WW, UK. Electronic address: Martin.Wiselka@uhl-tr.nhs.uk.
authors.forename: M J
authors.initials: MJ
authors.lastname: Wiselka
authors.affiliation: Department of Paediatrics, Leicester Royal Infirmary, Leicester LE1 5WW, UK. Electronic address: Deborah.Wilson@uhl-tr.nhs.uk.
authors.forename: D J
authors.initials: DJ
authors.lastname: Wilson
mesh_terms: D000293:Adolescent; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D005260:Female; D019983:Guideline Adherence; D006509:Hepatitis B / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology* / Q000517:prevention & control* / Q000635:transmission; D006514:Hepatitis B Surface Antigens / Q000097:blood; D017325:Hepatitis B Vaccines / Q000627:therapeutic use*; D006753:Hospital Records; D006784:Hospitals, Teaching; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D012189:Retrospective Studies; D013222:State Medicine; D006113:United Kingdom / Q000453:epidemiology; D019562:Viral Load; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D006514:Hepatitis B Surface Antigens; D017325:Hepatitis B Vaccines
keywords: Antivirals; Hepatitis B; Vertical infectious disease transmission