Hanson Josh, Radlof Sharna, Coffman Jenna, Lort-Phillips Kathy, Smith Simon, Hempenstall Allison, Preston-Thomas Annie
Department of Medicine, Cairns Hospital, Cairns, Queensland, Australia.
Kirby Institute, University of New South Wales, Sydney, NSW, Australia.
Commun Dis Intell (2018). 2025 Mar 25;49. doi: 10.33321/cdi.2025.49.026.
With optimal antenatal and perinatal care and immunisation, the risk of perinatal transmission of hepatitis B virus (HBV) approaches zero. However, it can be logistically challenging to deliver this care to culturally and linguistically diverse populations and to those individuals who are living in remote Australian communities. This study examined the management of pregnant women with chronic hepatitis B (CHB) and their children in Far North Queensland (FNQ). It was hoped that this would identify the successes and limitations of the current FNQ HBV programme which was established in June 2017.
We used the Queensland notifiable diseases register to identify every female of childbearing age (13-45 years) living in FNQ with CHB during the study period 1 January 2013 - 31 December 2023. We identified the children born to these women during the study period and assessed whether their care was concordant with current Australian HBV management guidelines.
We identified 261 women of childbearing age who had 148 live births during the study period: 93/148 children (63%) were born to First Nations Australian mothers; 58/148 (39%) were born to mothers who were born overseas; and 46/148 (31%) were born to mothers who lived in remote locations. After establishment of the FNQ HBV programme, 71/77 pregnancies (92%) had optimal antenatal HBV care; 71/77 (92%) had optimal perinatal HBV care; and 72/77 infants (94%) had complete HBV vaccination. There have been no children confirmed to be hepatitis B surface antigen (HBsAg) positive since the establishment of the FNQ HBV programme. However, only 70/148 children (47%) have had HBsAg testing.
Antenatal and perinatal care and infant vaccination is currently concordant with national HBV guidelines in > 90% of pregnancies in the FNQ region. There has been no confirmed mother-to-child HBV transmission since establishment of a local HBV programme, although improved child testing is necessary to substantiate this finding.
通过优化产前和围产期护理以及免疫接种，乙型肝炎病毒（HBV）围产期传播的风险接近零。然而，为文化和语言多样化的人群以及居住在澳大利亚偏远社区的个人提供这种护理在后勤方面可能具有挑战性。本研究调查了昆士兰远北地区（FNQ）慢性乙型肝炎（CHB）孕妇及其子女的管理情况。希望这能确定2017年6月设立的当前FNQ HBV项目的成功之处和局限性。
我们使用昆士兰法定传染病登记册，确定在2013年1月1日至2023年12月31日研究期间居住在FNQ的每一位育龄（13 - 45岁）CHB女性。我们确定了这些女性在研究期间出生的子女，并评估她们的护理是否符合当前澳大利亚HBV管理指南。
我们确定了261名育龄女性，她们在研究期间有148例活产：93/148名儿童（63%）的母亲是澳大利亚原住民；58/148名（39%）的母亲出生在海外；46/148名（31%）的母亲居住在偏远地区。在FNQ HBV项目设立后，71/77例妊娠（92%）获得了最佳产前HBV护理；71/77例（92%）获得了最佳围产期HBV护理；72/77名婴儿（94%）完成了HBV疫苗接种。自FNQ HBV项目设立以来，没有儿童被确诊为乙型肝炎表面抗原（HBsAg）阳性。然而，只有70/148名儿童（47%）进行了HBsAg检测。
在FNQ地区，目前超过90%的妊娠的产前和围产期护理以及婴儿疫苗接种符合国家HBV指南。自当地HBV项目设立以来，尚未有确诊的母婴HBV传播病例，不过需要改进儿童检测以证实这一发现。
