Reaching the 2030 global target of 0.1% hepatitis B surface antigen (HBsAg) prevalence among children will require the introduction of additional interventions. A new coordinated approach to tackling mother-to-child transmission of HIV, hepatitis B, and syphilis has been endorsed by Member States across the Western Pacific Region at the 68th session of the WHO Regional Committee for the Western Pacific.
Immunization programmes successfully reduced the hepatitis B surface antigen (HBsAg) prevalence from over 8% in 1990 to less than 1% among children in the Western Pacific Region, achieving the 2017 regional target ahead of time.
The complete hepatitis B vaccine series (birth dose plus two additional doses) induces protective antibody levels in more than 95% of infants. However, perinatal infection still occurs, especially among infants born to mothers with high hepatitis B viral load.
Reaching the global goal of 0.1% hepatitis B surface antigen (HBsAg) prevalence among children by 2030 will require the introduction of additional interventions through coordinated programming. This includes antenatal HBsAg screening, the potential use of maternal antiviral therapy and the use of hepatitis B immunoglobulin among infants born to HBsAg-positive mothers.
This needs to be provided through an incremental approach, ensuring and building upon high coverage of the timely hepatitis B vaccine birth dose and at least two additional doses to all infants. Where appropriate and feasible, HBsAg screening should be integrated with HIV and syphilis testing for pregnant women to provide further interventions for EMTCT of hepatitis B.
The Regional Framework for the Triple Elimination of Mother-to-child Transmission of HIV, Hepatitis B and Syphilis in Asia and the Pacific 2018–2030 proposes an integrated and coordinated approach towards achieving the triple elimination of mother-to-child transmission (EMTCT) of hepatitis B, HIV and syphilis – emphasizing the principle of mother-newborn-and-child-centred care and a human-rights-based approach for every child, mother, her partner and their family.