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Question 1: Should newborns of mothers with isolated antibodies to hepatitis B core antigen be immunised?
  1. Isabelle Pramana1,
  2. Ulrich Heininger2,
  3. Nicole Ritz2
  1. 1Department of Neonatology, University Children's Hospital Basel, Basel, Switzerland
  2. 2Paediatric Infectious Diseases and Vaccinology Unit, University Children's Hospital Basel, Basel, Switzerland
  1. Correspondence to Dr Isabelle Pramana, Department of Neonatology, University Children's Hospital Basel 4058, Switzerland; isabelle.pramana{at}ukbb.ch

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Scenario

The midwife calls you to assess a newborn in the delivery room. The pregnancy was uneventful, but the mother's serology results show the following: hepatitis B surface antigen (HBsAg) negative, antibodies against hepatitis B surface antigen (anti-HBs) negative, but antibodies against hepatitis B core antigen (anti-HBc) positive. You wonder if the baby is at risk for perinatal transmission of hepatitis B virus (HBV) requiring preventive measures at this time.

Structured clinical question

Does a newborn of a mother with isolated antibodies against hepatitis B core antigen need immunisation (intervention) to prevent perinatal infection with HBV (outcome)? If yes, what type and timing of immunisation?

Search strategy and outcome

We searched MEDLINE via PubMed (January 1950 to November 2013) for the following terms: “anti-HBc AND vertical transmission”, “anti-HBc AND vaccination AND newborn”, “vaccination AND newborn AND perinatal transmission AND hepatitis B”, “isolated antibody AND hepatitis B AND pregnancy/pregnant”. Two hundred and forty-three abstracts were screened, 11 were considered for full text review. Of those, four were eligible and seven were excluded: four did not address the main question, two provided no follow-up data …

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