Considerations of antiviral treatment to interrupt mother-to-child transmission of hepatitis B virus in China

International Journal of Epidemiology
Fuqiang CuiFujie Xu

Abstract

Treating high-risk women with antivirals in their third trimester is a promising intervention to further reduce perinatal transmission in neonates born to hepatitis B surface antigen positive [HBsAg(+)] mothers. We estimated the number of perinatal infections based on coverage and effectiveness of hepatitis B immunization. We compared cost-effectiveness of different approaches to identify high-risk women for antiviral treatment, by region and urban/rural residence. Of the 16.59 million live births in 2015, 1.04 million infants (6.3%) were born to HBsAg(+) mothers and 268 201 infants (1.6%) to HBsAg(+) and HBeAg(+) dual-positive mothers. Despite immunoprophylaxis, 51 478 perinatal hepatitis B virus (HBV) transmissions were estimated to have occurred from HBsAg and HBeAg dual-positive mothers in 2015. Using HBeAg or HBV viral load testing to identify high-risk pregnant women and to treat them with Tenofovir, the incremental cost ranged from US$68.2 million to US$90.3 million. Assuming HBV viral load testing is available and used to guide treatment and all women with HBV viral loads >200 000 IU/ml are treated, 25 912 infections would be averted at a projected cost of US$3500 per infection averted. Identifying high-risk pregnant wo...Continue Reading

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Citations

Jan 25, 2020·Frontiers of Medicine·Wenzhan JingMin Liu
Apr 11, 2020·Journal of Clinical and Translational Hepatology·Xueru YinJinlin Hou
Sep 25, 2020·Journal of Hepatology·Jessica HowellMargaret Hellard
May 20, 2021·International Journal of General Medicine·Mingshu ZhouNuo Yi

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