GynaePulse
Join the launch
Infections in pregnancyFree in the app

Hepatitis B

Screen every woman. Stop it reaching the baby.

Source: WHO 2020/2024 · UK Green Book

Steps

  1. HBsAg at booking. If positive: HBV DNA (or HBeAg if DNA is not available), LFTs, refer to hepatology.
  2. Tenofovir (TDF) 300 mg daily from 28 weeks to at least birth if HBV DNA 200,000 IU/ml or more, or HBeAg-positive where DNA is unavailable.
  3. Baby: hepatitis B vaccine within 24 hours of birth, then the routine schedule.
  4. HBIG within 24 hours for high-infectivity mothers (HBeAg-positive, very high DNA, acute infection).
  5. Breastfeeding is fine; CS is not needed for hepatitis B.
WHO 2024 also allows tenofovir for all HBsAg-positive pregnant women where DNA and HBeAg testing are unavailable.
A summary for trained clinicians. Always check the full guideline, the patient in front of you and your hospital's protocol. Spotted an error? Tell us.