title: Global elimination of mother-to-child transmission of hepatitis B: revisiting the current strategy.
abstract: Mother-to-child transmission (MTCT) of hepatitis B virus (HBV) is a major route of HBV transmission worldwide despite an existing immunoprophylaxis regimen. The implementation of immunoprophylaxis has been challenging, especially in low-income and middle-income countries, where MTCT is common, because of difficulty obtaining and delivering the monovalent HBV vaccine and the HBV immunoglobulin. Global control of the HBV epidemic will need improved prevention of MTCT. We discuss research gaps that hinder development of new options for the elimination of MTCT as well as policy changes that may help the current vaccine-based strategy to live up to its full potential. We propose that decreasing hepatitis B viral concentrations before delivery, along with HBV vaccine use, could provide an alternative strategy that would decrease MTCT of HBV.
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Johns Hopkins University, Baltimore, MD, USA; Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. Electronic address: cthio@jhmi.edu.
authors.forename: Chloe L
authors.initials: CL
authors.lastname: Thio
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Nan
authors.initials: N
authors.lastname: Guo
authors.affiliation: Department of Infectious Diseases, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, China.
authors.forename: Chan
authors.initials: C
authors.lastname: Xie
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Johns Hopkins University, Baltimore, MD, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Kenrad E
authors.initials: KE
authors.lastname: Nelson
authors.affiliation: Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Stephan
authors.initials: S
authors.lastname: Ehrhardt
mesh_terms: D005260:Female; D006509:Hepatitis B / Q000276:immunology* / Q000517:prevention & control*; D006510:Hepatitis B Antibodies / Q000276:immunology; D006514:Hepatitis B Surface Antigens / Q000276:immunology; D017325:Hepatitis B Vaccines / Q000276:immunology*; D006515:Hepatitis B virus / Q000276:immunology; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D009035:Mothers; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000276:immunology / Q000517:prevention & control / Q000821:virology
chemical_list: D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens; D017325:Hepatitis B Vaccines