Key Step Lacking in Preventing Perinatal Hep B Transmission

By Michael Smith, North American Correspondent, MedPage Today

Published: September 28, 2012

Reviewed by Zalman S. Agus, MD; Emeritus Professor, Perelman School of Medicine at the University of

Most babies born to mothers with hepatitis B (HBV) appear to get post-exposure prophylaxis as well as the full three-dose series of vaccine against the virus, the CDC is reporting.

But adherence to a key follow-up step – post-vaccination serologic testing – seems less complete, the agency reported in the Sept. 28 issue of Morbidity and Mortality Weekly Report.

About 25,000 infants are born every year in the U.S. to mothers who test positive for the hepatitis B surface antigen (HBsAg), the CDC report noted, and without intervention up to 90% of infants can become infected, increasing their risk for cirrhosis or early death.

For that reason, the CDC's Advisory Committee on Immunization Practices urges post-exposure prophylaxis with hepatitis B vaccine and hepatitis B immune globulin within 12 hours of birth. Exposed infants should also complete the three-dose HBV vaccine series.

To evaluate the effect of the treatment, the committee has recommended, babies should be tested – a month after the last dose of vaccine -- for the HBV surface antigen and for the antibodies against it.

To see how well those recommendations were being carried out, the agency studied outcomes at 24 months for babies whose HBV-positive mothers were enrolled during 2008–2009 in five Enhanced Perinatal Hepatitis B Case Management Projects.

All told, the five projects -- in Florida, Michigan, Minnesota, New York City, and Texas -- managed 5,075 infants, of whom 4,214 had been given at least three doses of HBV vaccine by the age of 24 months.

But post-vaccination serologic testing took place in only 3,244 children (77%) of those who got their three shots.

Of those, the CDC analysis found, the testing was incomplete in 412, including 41 tested only for antibodies and 371 tested only for the surface antigen.

The date of testing was not reported for 561 children.

Of the 2,683 children with both testing and dates reported, the agency found, 93.3% were protected, 3.2% remained susceptible but were not infected, and 1.2% were infected. The remaining 2.3% had indeterminate results.

The rates of post-vaccination serologic testing have been rising, the agency noted – in one study from about 25% in 1994 to 56% in 2008.

But "this analysis highlights areas in need of improvement," the CDC report said, adding that strategies are needed to increase overall testing rates, as well as complete testing for both antibodies and the surface antigen, which are needed to confirm outcomes.

The study, the agency report cautioned, is based on five HBV perinatal case management projects and might not be representative of all births to women with HBV infection.

The analysis was conducted by the CDC and state and local health departments. The authors are employees of those agencies.

Primary source: Morbidity and Mortality Weekly Report
Source reference:
Centers for Disease Control and Prevention "Postvaccination Serologic Testing Results for Infants Aged ≤24 Months Exposed to Hepatitis B Virus at Birth -- United States, 2008–2011" MMWR 2012; 61: 768-771.

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Book “Einstein’s Table” Tells Story of Hepatitis B

Release Date: 2012-05-01

“Einstein’s Table: The Search to Find a Cure for Chronic Hepatitis B,” by Kimberly Jungkind, Raises Awareness and Chronicles Hepatitis B Foundation’s Inspirational Story

FOR IMMEDIATE RELEASE / PRURGENT

DOYLESTOWN, PA (May 2012) – The inspirational story of the Hepatitis B Foundation of Doylestown, Pa., has been chronicled in a new book, “Einstein’s Table: The Search to Find a Cure for Chronic Hepatitis B,” authored by Kimberly Jungkind, a Foundation board member. The book’s release comes during May which is National Hepatitis Awareness Month. There will be a book signing offered during the Foundation’s “B Informed” Parent Conference, a free event for parents of children with hepatitis B, to be held on May 19, 2012 at Holiday Inn Express Midtown in Philadelphia.

The only national nonprofit organization dedicated solely to finding a cure for hepatitis B and improving the quality of life for those affected worldwide, the Hepatitis B Foundation began its journey more than 20 years ago. Founders Paul and Janine Witte and Dr. Timothy and Joan Block were moved by the plight of a young family affected by hepatitis B. Dismayed that the affected family had nowhere to turn for support, the Wittes and Blocks gathered at Albert Einstein’s guest cottage in Bucks County, Pa., for a brainstorming session, and the Hepatitis B Foundation was born.

“If the strength and commitment of a community can make a difference in one person’s life in Pennsylvania, imagine what it can do for people across the nation and around the world,” said Jungkind. “I, too, share the dream of the Hepatitis B Foundation’s founders that this disease will be cured and eliminated in our lifetime.”

Jungkind is a nurse clinician and healthcare marketer with nearly 20 years of experience in the healthcare industry. She has lectured nationally on chronic diseases and disease management, and authored more than 15 articles and texts addressing disease management, clinical topics and information technology. Jungkind is the recipient of the Aster Award for Medical Marketing, two Healthcare Advertising Awards, a Dorland Health People Award, a Web Marketing Association Award, Merck’s Most Amazing Woman award and Wyeth’s President’s Golden Circle Award. “Einstein’s Table: The Search to Find a Cure for Chronic Hepatitis B” is available in soft and hard back editions through Amazon.com, with all proceeds benefitting the Hepatitis B Foundation. To learn more, go to http://hepb.org/einsteins_table.htm .

“We are grateful to Kim for telling the story of the Hepatitis B Foundation and raising awareness of this deadly disease,” said Foundation Executive Director and Co-founder Joan Block. “We are also indebted to her for the 15 years of dedicated service to our Board of Directors. Kim has been a valuable resource to our organization and we look forward to continuing our work together.”

Hepatitis B is the most common serious liver infection and the major cause of liver cancer worldwide. Nearly 2 billion people have been infected with the hepatitis B virus (1 out of 3) and 400 million are chronically infected. Each year, 1 million people die prematurely from hepatitis B-related liver disease and liver cancer. In the U.S., an estimated 2 million Americans are chronically infected with hepatitis B – that is 1 in 20. The good news is that hepatitis B is preventable and treatable. However, for the 400 million people living with chronic hepatitis B infections, there is still no complete cure.

About the Hepatitis B Foundation: The Hepatitis B Foundation is the only national nonprofit organization solely dedicated to finding a cure for hepatitis B and improving the quality of life for those affected worldwide through research, education and patient advocacy. To learn more, go to www.hepb.org, read our blog at http://wp.hepb.org, follow us on Twitter @HepBFoundation, find us on Facebook at www.facebook.com/hepbfoundation  or call (215) 489-4900.

Contact Info
Furia Rubel Communications
2 Hidden Lane
Doylestown, PA 18901
Phone: 215-340-0480
Website: http://www.hepb.org

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Hepatitis Health Action Alert: Stop the Attacks on Prevention and Public Health Fund

Posted on January 23, 2012 on The Hepatitis B Foundation blog

Action Alert! The Hepatitis Community Responds to Health Care Reform. Tell Congress Not To Cut The Prevention and Public Health Fund

The Prevention and Public Health Fund is under attack in Congress once again. Some leaders in the House of Representatives would like to make drastic cuts to the Fund as part of negotiations on a long-term deal on the payroll tax cut and Medicare payments rates to medical providers.

The Prevention and Public Health Fund, part of the Affordable Care Act, provides money each year for vital prevention and public health services. The fund will grow each year until it eventually provides $2 billion/year.

This fund is extremely important to the nation’s fight against the viral hepatitis epidemic. Later this year, the Department of Health and Human Services is expected to allocate $10 million from the Fund for viral hepatitis screening, testing, and education programs. This initiative will greatly help efforts to identify the millions of Americans who have chronic hepatitis B or C and link them to care and treatment.

Please take a few minutes to call Congress in support of this lifesaving program!

What YOU can DO:

Please call your U.S. House Representative and two U.S. Senators immediately. We are hearing directly from Congressional staff that phone calls are the most effective form of communication.

Call the Capitol Switchboard toll-free at 1-888-876-6242 and ask to be connected to your United States Representative. When you reach your Representative’s office, tell whoever answers the phone that you are a constituent and that you would like to speak to the staff person who handles health care issues. Whether you speak to the staff person live or leave a voicemail, tell him/her:

“My name is _______________ and I live in (city/state). I am calling in strong support of the Prevention and Public Health Fund, which is an important part of the Affordable Care Act. This Fund is a great opportunity to provide badly needed funding for viral hepatitis prevention, testing, and screening programs and must be preserved. I urge Representative_____________ to oppose any efforts to cut the Fund as part of the payroll tax/Medicare physician reimbursement negotiations.”

After you speak to your Representative’s office, call the Capitol Switchboard again and deliver the same message to the health care staff person in your two U.S. Senators’ office.

Thank you for taking the time to make a difference! Please spread the word.

Get involved with Hepatitis Health Action!

• Sign up for the Hepatitis Health Action email list by visiting http://groups.google.com/group/HepHealth or, email rclary@projectinform.org and we will make sure you are added.

• Join Hepatitis Health Action’s Facebook group: http://tinyurl.com/hephealthfacebook where you can participate in discussions with other advocates and share your ideas and strategies.

Hepatitis Health Action is a campaign led by viral hepatitis advocates working to make sure that health care reform addresses hepatitis B and C.