I (male) am a carrier but my wife is negative for Hep B. I know when the mom is negative there is a lower chance for baby to have it. But is it still possible for the baby to get it? Would the vaccine need to be given right away after birth to the baby or would it be fine to wait until they would normally give it (which from my understanding isn’t immediately after birth)
We’re not expecting but I was just curious.
Anyone in a similar situation?
In many countries the first dose of a hepatitis B vaccine is given to the child right after birth.
To minimize the risk of the child getting infected:
I’m myself a hepatitis B carrier and a father of two healthy kids.
If your wife is vaccinated and immune prior to getting pregnant, there is no chance of the baby being infected. If she’s not immune, it’s possible that you could pass HBV to her sexually during pregnancy, especially if you are not on antivirals. In the case of a new (acute) infection during pregnancy, it’s very possible for the baby to contract chronic HBV, even if the mother ends up clearing the infection later.
All of that being said, the safest thing to do is to make sure that she is immune to HBV before starting a family together. There is a small percentage of people who don’t respond to the vaccine, so it would be a good idea to get serological testing after she’s completed the vaccine series to make sure she has antibodies. In terms of giving the vaccine to the child, you don’t necessarily need to give it immediately after birth. Risk of contracting HBV from a household member is very low if you avoid sharing personal care items (e.g. razors, toothbrushes).
If the mother is HBV negative, then vertical transmission to the baby is nil. However, the baby should still have the standard HBV vaccination schedule (first dose usually within the first 24 hours, and is followed by three more doses at 6 weeks, 4 months, and 6 months of age to ensure long-term protection). It is a protection against HBV infection, not just from family members but from everybody. I agree the mother should also be vaccinated.
These are all good and accurate replies.
The only thing I have to add is that the risk of transmission to the baby from an infected father would be identical to the risk of transmission from any other HBV+ person that spends a lot of time with the child. The risk factor is transfer of blood from the father to the child. That is unlikely, but being careful when you have a cut would be a good idea. Of course, if the child receives the birth dose of the vaccine, completes the vaccination series, and is a responder to the vaccine (93 to 95% of people respond well to it), then the risk of transmission is negligible. Suppressing HBV levels in the father with antivirals further reduces risk of transmission. Consequently, it is perfectly possible to safely start a family when the father is HBV+ and the mother is HBV-.
John.
To be clear, I still think birth dose vaccination is best, and it’s what the WHO recommends. But I know some countries don’t do this routinely. I know some countries start at 2 months old, for instance, and this is probably not the end of the world if your wife is not infected, and has been vaccinated. You can certainly ask for the baby to be vaccinated at birth if that is not routine in your country. Hopefully they will give it to you, but even if they say that it’s not necessary, the overall risk of transmission is still low.
In my case, I was adopted from China, and my parents didn’t know that I had hepatitis B at the time that I was adopted. We didn’t find out until 12 years later. Nobody in the family was vaccinated, because the vaccine didn’t exist when my parents were children, and I guess there were no universal public health recommendations for adults to get the vaccine, even after it was added to routine childhood immunizations.
Of course, everyone got tested after I was diagnosed, and thankfully nobody else had it. They all went and got the vaccine. Also my viral load was in the hundreds of millions at the time.
Thanks @mantana ! Does the father need to be on antiviral if his viral load is low?
Thanks @john.tavis if the viral load of the father is low should he still be on antiviral before thinking of starting a family to further prevent risk? Even if he otherwise wouldn’t need to be on antiviral?
Thanks @et5656 ! Thankfully my wife is fully vaccinated and responded well to the vaccine. Even though it’s said it should last a lifetime she still gets tested yearly during her routing checkups to ensure her vaccine is still effective (just in case!) so thankfully she is safe from it. I was just concerned as to if the father could pass it to the baby at time of conception if he is positive but she is not
Hi @Anon2023,
The most important things to do to stop transmission are for your wife and child to be vaccinated. That reduces their risk to zero if they respond as your wife did. Reducing HBV levels in the father will reduce the risk of transmission by all routes and to all potential contacts, but it will not necessarily reduce the risk to zero (I’m not sure that the studies have been done to determine that). So the vaccine makes a solid wall against transmission, whereas treating a HBV+ person turns down transmission risk, similar to a dimmer switch on a light, with the risk of transmission being roughly proportional to the HBV DNA levels in blood.
I hope this helps.
John.
@Anon2023 I haven’t heard of any instances of sperm from an HBV+ father causing infection to a baby when it fertilizes the egg. But I also haven’t done my own research on this issue.
Hi @Anon2023, this is incredibly unlikely and no study has ever shown this occurring. I would not worry about this possibility.
Thomas