Prevention of Mother-to-Child (Perinatal) Transmission of Hepatitis B

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Last updated: December 16, 2008

A 34-year-old woman with a history of injecting drug use presents for her first prenatal visit at 10 weeks gestation. She reports use of intravenous and nasal heroin in the past, but states she has been in recovery for seven years and has not used any drugs or alcohol during that time. She is currently in a monogamous relationship with a man who is the father of her child. She and her partner were both tested about a year ago for HIV when they decided to have children and were found to be HIV negative. She has never been tested for hepatitis B virus (HBV) infection. Her review of systems is notable for occasional early morning nausea, but is otherwise unremarkable. Her physical examination is normal and fetal heart tones are detected.

Which of the following is the most important step in evaluating this patient with regard to her hepatitis B status?

A No testing for hepatitis B is indicated since it is highly likely that she received hepatitis B vaccine as a child or as an adolescent.
B No testing for hepatitis B is indicated; begin a three dose series of hepatitis B vaccine.
C Check her serum for hepatitis B surface antigen (HBsAg).
D Check her serum for antibody to hepatitis B e antigen (anti-HBe).