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Obstetrics & Gynecology 2002;99:1049-1052
© 2002 by The American College of Obstetricians and Gynecologists
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ORIGINAL RESEARCH

Risk of Hepatitis B Transmission in Breast-fed Infants of Chronic Hepatitis B Carriers

James B. Hill, MD, Jeanne S. Sheffield, MD, Matthew J. Kim, MD, James M. Alexander, MD, Barbara Sercely, RN and George D. Wendel, Jr, MD

From the Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center at Dallas and the Dallas County Health Department, Dallas, Texas.

Address reprint requests to: James B. Hill, MD, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center at Dallas, 5323 Harry Hines Boulevard, Dallas, Texas 75235-9032; E-mail: james.hill{at}utsouthwestern.edu.

OBJECTIVE: To measure the rate of hepatitis B (HBV) transmission from chronic HBV carriers to breast-fed infants after immunoprophylaxis.

METHODS: Since 1992, information on women with HBV during pregnancy has been collected in a prospective longitudinal study. Those HBV carriers and their infants participating in a county HBV immunoprophylaxis program were identified. Infants were followed for up to 15 months and examined for hepatitis B infection by hepatitis B surface antigen (HBsAg).

RESULTS: A total of 369 infants born to women with chronic HBV met the inclusion criteria and received hepatitis B immune globulin at birth and the full course of the hepatitis B vaccine series. We compared 101 breast-fed infants with 268 formula-fed infants. There was no significant difference between the two groups with respect to the number of women who were positive for hepatitis B e antigen (HBeAg) (22% versus 26%, P = .51). Three women in the breast-feeding group had liver transaminase abnormalities, compared with six women in the formula-feeding group (P = .29). Overall, there were nine cases of HBV infection transmission (2.4%). None of the 101 breast-fed infants and nine formula-fed infants (3%) were positive for HBsAg after the initial vaccination series (P = .063). The mean length of time for breast-feeding was 4.9 months (range 2 weeks to 1 year).

CONCLUSION: With appropriate immunoprophylaxis, including hepatitis B immune globulin and hepatitis B vaccine, breast-feeding of infants of chronic HBV carriers poses no additional risk for the transmission of the hepatitis B virus.






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