title: Applicability and efficacy of a model for prevention of perinatal transmission of hepatitis B virus infection: single center study in Egypt.
abstract: OBJECTIVE
  To identify possible maternal risk factors for hepatitis B virus (HBV) acquisition and assess the efficacy of immunoprophylaxis given to infants born to hepatitis B virus surface antigen (HBsAg) positive mothers.
  
  
  METHODS
  Screening of 2000 pregnant females was carried out using rapid test and confirmed by enzyme immunoassay. A questionnaire consisting of 20 questions about the possible risk factors for acquisition of HBV infection was filled for every pregnant HBsAg positive female in addition to at least 2 pregnant HBsAg negative females for each positive case. Infants of HBsAg positive women were offered passive and active immunoprophylaxis within the 1st 48 h after birth, in addition to 2nd and 3rd doses of HBV vaccine after 1 and 6 mo respectively. Infants were tested for HBsAg and hepatitis B surface antibodies (HBsAb) at six months of age.
  
  
  RESULTS
  HBsAg was confirmed positive in 1.2% of tested pregnant women. Risk factors significantly associated with HBV positivity were; history of injections (OR = 5.65), history of seeking medical advice in a clinic (OR = 7.02), history of hospitalization (OR = 6.82), history of surgery (OR = 4) and family history of hepatitis (OR = 3.89) (P < 0.05). Dropout rate was 28% for HBsAg women whose rapid test was not confirmed and could not be reached to provide immunoprophylaxis for thier newborns. Immunoprophylaxis failure was detected in only one newborn (3.7%) who tested positive for HBsAg at 6 mo of age; and vaccine failure (seronegative to HBsAb after 4 doses of the vaccine) was detected in another one (3.7%). The success rate of the immunoprophylaxis regimen was 92.6%.
  
  
  CONCLUSIONS
  This pilot study shows that a successful national program for prevention of perinatal transmission of HBV needs to be preceded by an awareness campaign to avoid a high dropout rate.
authors.affiliation: Hanaa M El-Karaksy, Lamiaa M Mohsen, Noha A Yassin, Mohamed Farouk, Mortada H El-Shabrawi, Department of Pediatrics, Kasr Al-Ainy School of Medicine, Cairo University, Cairo 11562, Egypt.
authors.forename: Hanaa M
authors.initials: HM
authors.lastname: El-Karaksy
authors.affiliation: Hanaa M El-Karaksy, Lamiaa M Mohsen, Noha A Yassin, Mohamed Farouk, Mortada H El-Shabrawi, Department of Pediatrics, Kasr Al-Ainy School of Medicine, Cairo University, Cairo 11562, Egypt.
authors.forename: Lamiaa M
authors.initials: LM
authors.lastname: Mohsen
authors.affiliation: Hanaa M El-Karaksy, Lamiaa M Mohsen, Noha A Yassin, Mohamed Farouk, Mortada H El-Shabrawi, Department of Pediatrics, Kasr Al-Ainy School of Medicine, Cairo University, Cairo 11562, Egypt.
authors.forename: Doa'a A
authors.initials: DA
authors.lastname: Saleh
authors.affiliation: Hanaa M El-Karaksy, Lamiaa M Mohsen, Noha A Yassin, Mohamed Farouk, Mortada H El-Shabrawi, Department of Pediatrics, Kasr Al-Ainy School of Medicine, Cairo University, Cairo 11562, Egypt.
authors.forename: Mona S
authors.initials: MS
authors.lastname: Hamdy
authors.affiliation: Hanaa M El-Karaksy, Lamiaa M Mohsen, Noha A Yassin, Mohamed Farouk, Mortada H El-Shabrawi, Department of Pediatrics, Kasr Al-Ainy School of Medicine, Cairo University, Cairo 11562, Egypt.
authors.forename: Noha A
authors.initials: NA
authors.lastname: Yassin
authors.affiliation: Hanaa M El-Karaksy, Lamiaa M Mohsen, Noha A Yassin, Mohamed Farouk, Mortada H El-Shabrawi, Department of Pediatrics, Kasr Al-Ainy School of Medicine, Cairo University, Cairo 11562, Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Farouk
authors.affiliation: Hanaa M El-Karaksy, Lamiaa M Mohsen, Noha A Yassin, Mohamed Farouk, Mortada H El-Shabrawi, Department of Pediatrics, Kasr Al-Ainy School of Medicine, Cairo University, Cairo 11562, Egypt.
authors.forename: Mohamed E
authors.initials: ME
authors.lastname: Salit
authors.affiliation: Hanaa M El-Karaksy, Lamiaa M Mohsen, Noha A Yassin, Mohamed Farouk, Mortada H El-Shabrawi, Department of Pediatrics, Kasr Al-Ainy School of Medicine, Cairo University, Cairo 11562, Egypt.
authors.forename: Mortada H
authors.initials: MH
authors.lastname: El-Shabrawi
mesh_terms: D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D004534:Egypt / Q000453:epidemiology; D005260:Female; D006509:Hepatitis B / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission*; D006510:Hepatitis B Antibodies / Q000097:blood; D006514:Hepatitis B Surface Antigens / Q000097:blood; D017325:Hepatitis B Vaccines / Q000008:administration & dosage*; D006801:Humans; D007115:Immunization Schedule; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D016017:Odds Ratio; D010352:Patient Dropouts; D010865:Pilot Projects; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D015995:Prevalence; D015397:Program Evaluation; D011446:Prospective Studies; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens; D017325:Hepatitis B Vaccines
keywords: Egypt; Hepatitis B virus; Hepatitis B virus surface antigen positive mothers; Immunoprophylaxis; Perinatal transmission