DETECTION OF HEPATITIS-B SURFACE-ANTIGEN IN PREGNANT-WOMEN ATTENDING A PUBLIC HOSPITAL FOR DELIVERY - IMPLICATION FOR VACCINATION STRATEGY IN BANGLADESH

Routine antenatal hepatitis B surface antigen (HBsAg) screening and im munization of risk babies is very effective in preventing perinatal tr ansmission of hepatitis B virus (HBV). We studied 1,800 parturients at tending a public hospital to assess the rationale for such vaccination in Bangladesh. In one in every 29 deliveries (63 of 1,800 or 3.5%), t he mother was found to be HBsAg positive. All were asymptomatic and ma ny (41 of 63 or 65%) without risk factors would remain undetected if H BsAg screening were performed on selected groups. Most of the HBsAg-po sitive mothers (54 of 63 or 85.7%) were found to be chronic carriers a nd 30.2% (19 of 63) were also hepatitis B e antigen (HBeAg) positive, indicating high infectivity. Although 23 cord blood were positive for HBsAg or HBeAg, none were positive for IgM antibody to hepatitis B cor e antigen (IgM anti-HBc), suggesting transplacental transmission of th e antigens rather than intrauterine infection. These findings are disc ussed in relation to the: cost-effectiveness of routine prenatal scree ning and immunization of risk babies compared with universal infant im munization.