Public Release Type:
Journal
Publication Year: 2013
Authors:
Terrault N,
Khalili M,
Bzowej NH,
Lau D,
Li R,
Smith C,
Tran TT,
Tsai N,
Yim C
Studies:
Hepatitis B Research Network
Background: Hepatitis B virus (HBV) transmission persists despite effective perinatal measures including the use of HBIG and HBV vaccination (VAC) to prevent HBV transmission from HBsAg + mothers to their infants. Maternal knowledge may play a role in prevention of perinatal transmission. We aimed to assess maternal knowledge of HBV testing and diagnosis in their children as well as rates of HBV vaccination (VAC) and HBIG within the NIDDK-funded Hepatitis B Research Network. Methods: Adult women with chronic HBV who reported being previously pregnant completed an additional survey assessing their knowledge of the testing or diagnosis of HBV and the administration of VAC and/or HBIG to their biological and adopted children. Results: From 1/1/2011 to 3/18/2013, 787 women were enrolled into the HBRN adult cohort. 539 were previously pregnant and 482 reported at least 1 live birth (total of 1106 children). Median age of the 482 women was 45 (19-75) years; 10% White, 13% Black, 74% Asian, and 4% other; The presumed mode of HBV infection was available for 354: 62% vertical, 37% horizontal and 1% other; 14% of women did not know the HBV status of their child. Maternal age, race, income, education or place of birth did not affect knowledge of child’s HBV infection. Women with known mode of transmission of HBV more often knew the HBV status of their child compared to those with unknown mode (88% vs. 78% p=0.01). Administration of perinatal HBIG to the child was unknown by the mother in 27% while VAC administration was unknown in 13%. Multiple logistic regression models suggest that lack of VAC knowledge was associated with lower levels of education (high school or less) (OR=1.9 CI 1.1-3.3 p=0.02) and age>40 years (OR=3.1 CI 1.6-6.1 p=0.001). If presumed mode of transmission was unknown for the women (vs. known), it was more likely that VAC status of the child was also unknown (OR=1.9 CI 1.1-3.4 p=0.02). HBIG knowledge reflected similar differences by educational status, maternal age, and knowledge of mode of transmission. No differences in VAC/HBIG knowledge were noted between maternal race or maternal continent of birth. Conclusions: Fourteen percent of North American women with HBV did not know whether their children were infected with HBV. HBV vaccination status was unknown to the mother in 13% of children and HBIG administration was unknown in 27%. Knowledge disparities by educational attainment and age show opportunities in patient based educational programs.