Having children and Hepatitis B

Please my name is Everich I really have a serious question to ask and it goes like this…My wife was diagnosed with hepatitis B positive but I myself tested negative twice… please it’s possible for us to still have kids without infecting me or our baby?

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Hi Everich,

First of all, welcome to the forum. I hope you find what you’re looking for here. I have moved your question to a separate topic because I think it’s an important question that should be easily searchable by anyone thinking the same thing (it is a common situation!).

To answer your question simply, yes it is possible to have children when the mother has a HBV infection without infecting the child or partner!

There are several things you can do to make sure everyone stays safe:

Vaccination: You should be vaccinated against HBV and confirm that your antibody levels are high enough to prevent infection. Also, the new-born should vaccinated against HBV straight away (within 24 hours of birth), followed by 2 follow-up doses after 6 weeks and 4 months (Australia also recommends another at 6 months). This is 90% effective in preventing infection of the new-born.

Antiviral treatment: The mother can also take antiviral treatment (e.g. Tenofovir) while pregnany before giving birth. The virus does not cross into the womb; instead infection only happens during the birth procedure. Antivirals will lower the amount of virus in the mother’s blood to prevent the baby from being exposed to a lot of the virus. Antivirals will also limit the exposure of the partner to the virus.

Antibody therapy: The new-born can also be given antibody therapy (also known as HBIG). This is given within 24 hours of birth and helps the baby’s immune system to neutralise any virus from the mother.

I hope this helps. Happy to answer any more questions. Perhaps some other @HealthExperts can chime in with any additional things I might have missed?

Cheers,
Thomas

Ok thank you for your response… tomorrow I have to go for a checkup testing again for me to make sure I’m properly protected…I can’t wait to have a child with my wife this year.
Glad I won’t be infected or our baby, hopefully my wife gonna be cured from this virus…I do cry for my beloved wife all time since she was diagnosed with hbv. God help.

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Hi Everich,

This is John Tavis, a senior HBV virologist and researcher. Thomas’ comments are right on the mark. With proper preparation and medical care as he describes, you can have a child safely. Introduction of these practices has caused the rate of chronic infection among children to drop sharply, which is a true medical success! I have two children of my own (grown-up now), and being a parent is the greatest joy of my life. I am happy that you will be able to experience that joy also!

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But what are the chances. Not trying to be negative, but the risk seems too great. If there was even 90% chance of no transmission, that 10% would not be a risk I would not be willing to take for my baby from day 1.

But I am no expert, so it’s just an option

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Hi Johnny,

The 90% is if you only depend on the vaccine and the mother has a high viral load. When you combine these measures (including the antiviral treatment and HBIG), the rates of transmission are really very very low. I have seen meta-analyses showing that antiviral treatment reduces the risk by another 90% (combined = 99% effective).

There are also different levels of risk with respect to the mother - HBeAg-positive mothers are more likely to transmit compared to those who are HBeAg-negative.

Thomas

Yes my wife is positive but I myself is negetive…so are you saying some chances maybe happen the virus can be passed on to our baby ? Or even me even though I’m gonna be taking vicines of proper testing to be sure I’m good.

Hi Everich,

If your wife takes the measures that I described (vaccination, antiviral treatment, and antibody treatment) then the chance of passing it on to your baby is extremely low.

If you are vaccinated and have sufficient antibody levels, then the chance of you getting infected is almost zero.

Thomas

Hi Everich, I want to add my two cents since I have lived with chronic hepB for 60 years and have so far lived a very healthy and happy life. I’m married with 2 grown children and just recently became a grandmother. So I can reassure you that your wife should expect to live a long and healthy life, too. My best advice for you is to have her see a doctor who is knowledgeable about hepatitis B since she can be evaluated now before giving birth to see if treatment should be started in her last 3 months. Also, after she gives birth to your baby, she will need to monitored regularly to care for the health of her liver longterm.

Finally, I want to give you an action plan based on what Thomas and John wrote above about how best to protect your newborn baby from getting infected with hepB so you completely understand what needs to be done.

(1) Have your wife see a doctor now who can evaluate whether she needs treatment for hepb during her last 3 months (treatment would decrease the amount of virus in her blood).
(2) Tell the doctor who is going to deliver your baby that your wife has hepB and your baby will need the first dose of the hepB vaccine and one dose of HBIG (hepB immunoglobulin) immediately after birth.
(3) Make sure that the doctor or hospital has the first dose of hepB vaccine and one dose of HBIG available the day you arrive so your baby can be given both drugs immediately after being born. Both of these drugs are given by injection.
(4) The BEST is if both the first dose of hepB vaccine and HBIG are given immediately after your baby is born, before they go to the nursery. There is no 2nd chance to protect your baby, and if the hospital delays giving these drugs that would be a big problem.

Although the World Health Organization says there is a 24-hour window to protect your baby from hepB, the United States CDC guidelines say 12 hours, and the Hep B Foundation recommends both the vaccine and HBIG be given in the delivery room for maximum insurance that your baby will be protected from an infection.

This is a very long response, but I’m emphasizing the importance of protecting newborns from hepB immediately. Thanks and best wishes on the birth of your new baby!!! What a wonderful experience … Joan

Thank you for your contributions but I’m also worried if I’m safe since I’m negetive hoping the virus won’t infect me during intercourse

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Hi Everich, if your antibody levels are high enough, there is very very little risk of you getting a chronic HBV infection during intercourse. There are many instances of couples being together for decades and having children without infecting their partners. This has been possible because the vaccine is so effective in preventing transmission.

Thomas

Dear Everich,

Your best protection is vaccination because that is extremely effective in blocking transmission via sex. The published efficacy rates for the vaccine are around 95% for generating sufficient antibodies. Transmission when your HBV antibodies (called anti-HBsAg) from the vaccine are >10 IU/ml is extremely rare. Your medical provider can do a simple blood test to measure your anti-HBsAg antibody levels. Using a condom will further reduce the risk. I hope this helps.

John.

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Yes I agree with Thomas and John that you should be vaccinated and this will protect you against infection. For planning pregnancy I support Joan’s detailed action plan. The minimum is for your baby to receive HBV vaccine and HBIG (antibody) as soon as possible after birth, which is very effective at preventing infection in the baby. If your wife has very high levels of virus in the blood then I would also recommend antiviral therapy in the third trimester to further reduce the risk. You should see someone with expertise in this to confirm the best approach for you and your wife.
This is definitely something that can be sorted out and should not put you off having children if that is what you want to do.
Good luck!

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Sorry to ask again from here… please what can of test I need to do because I myself is negative while my partner is positive with hepatitis B…so please what can of lab test I need to do so I will be sure that I’m fully protected because we really want to have kids asap

Hi everich,

To find out if you’re protected, you need to test for your hbsab (hepatitis b virus surface antibody) levels. You are protected if they are above 12 units.

If it is below this, you can get another course of vaccinations that can boost your levels.

Cheers,
Thomas

Yes I agree with Thomas that the anti-HBsAb is the key test to check whether you are protected.
We always recommend doing HBsAg and anti-HBcAb initially as well, just to be sure that you don’t already have hepatitis B or that you haven’t had it before and cleared it naturally. Interpretation of all these tests can be a bit complicated so best to discuss the tests and results with your doctor to make sure you understand what it all means.

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Hello sir
I was advised to do antibody test for hepatitis b because my wife was diagnosed with hepatitis b positive and we planning to have kids…so I was afraid to have kids with my beloved wife and I really don’t wanna leave her because of this illness…I wanna be with her husband till the end of life…

Now here comes my hepatitis b antibody report…

SPECIAL SEROLOGY

Test Name:ANTI HBs ANTIBODY
Chemiluminescent microparticle
immunoassay (CMIA)

Test Result: 104.55 mIU/mL

Now I’m I fully protected from getting hepatitis b? Because I wanna start having kids with my beloved wife.

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Hi Everich,

This lab result indicates that YES you are protected against Hepatitis B infection.

Thomas

Hello sir I have attached a photo of my antibody test report as I was directed to check my antibody because my wife was diagnosed with hepatitis b.

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