Perinatal Transmission of Hepatitis B
Description Medicine treatment P00.2 DESCRIPTION Babies born to mothers with acute hepatitis B infection at the time of delivery or to mothers who are HBsAg-positive or HBeAg-positive. MEDICINE TREATMENT Hepatitis B immunoglobulin, IM, 0.5 mL within 12 hours of delivery. LoE:IVb 37 AND Hepatitis B vaccine, IM, 0.5 mL, first dose within 12 hours of delivery. Continue hepatitis B immunisation
Description
Medicine treatment
P00.2
DESCRIPTION
Babies born to mothers with acute hepatitis B infection at the time of delivery or to mothers who are HBsAg-positive or HBeAg-positive.
MEDICINE TREATMENT
- Hepatitis B immunoglobulin, IM, 0.5 mL within 12 hours of delivery.
LoE:IVb37
AND
- Hepatitis B vaccine, IM, 0.5 mL, first dose within 12 hours of delivery.
- Continue hepatitis B immunisation according to the recommended immunisation schedule.
LoE:IVb38
- Check the baby's hepatitis B surface antigen (HBsAg) and hepatitis B surface antibody (HBsAb) at 9 months:
- If HBsAg positive: baby has hepatitis B infection – refer.
- If HBsAg negative and HBsAb negative: repeat vaccination with hepatitis B containing vaccine, with a repeat dose in 1 month. Repeat HBsAb one month after the second dose; if still HBsAb negative then refer.
- If HBsAb positive: baby is immune to hepatitis B. Reassure parents, no further testing required.
Note:
Do not check hepatitis B serology before 9 months of age as antibodies from the birth dose of immunoglobulin might still be present. Refer if hepatitis B serology is not available.
Standard Treatment Guidelines and Essential Medicines List for South Africa, Primary Healthcare, 2025-9_Version 1.0_26 March 2026
Chapter 6: Obstetrics and Gynaecology_6.6.5 Perinatal Transmission of Hepatitis B