2020 clinical guidelines on prevention of mother-to-child transmission of hepatitis B virus

Mother-to-child transmission( MTCT) of hepatitis B virus( HBV) is the main cause of chronic hepatitis B( CHB) in China,and the prevention of MTCT plays a critical role in controlling CHB. Based on Clinical guidelines for the prevention of mother-to-child transmission of hepatitis B virus( First Edition) issued in 2013,the current clinical guidelines have updated the recommendations,mainly including:( 1) all pregnant women should undergo the prenatal screening for hepatitis B serological markers;( 2) neonates whose mothers have negative HBsAg should receive hepatitis B vaccination according to the regimen of “0,1,and 6 months”,and there is generally no need for hepatitis B immunoglobulin( HBIG);( 3) neonates whose mothers have positive HBsAg need intramuscular injection of HBIG at one dose and the first dose of hepatitis B vaccine within 12 hours after birth( the sooner the better),followed by injection of the second and third doses of hepatitis B vaccine at the age of 1 and 6 months,respectively;( 4) to further reduce MTCT of HBV,pregnant women with HBV DNA > 2 × 105 IU/ml or with positive HBe Ag may start to take oral antivirals at the 28-32 weeks of gestation until the day of delivery;( 5) cesarean section,with the purpose to reduce MTCT of HBV,is not recommended.