Peer-reviewed article
Effectiveness of timely hepatitis B birth dose vaccination to prevent mother-to-child transmission in Ethiopia
Nega Berhe, Hailemichael Desalegn, Hiwot Mengistu, Dawit Brhane, Birhanu Kebede et al. ·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5-5This study looked at whether giving hepatitis B vaccine at birth stops mothers with hepatitis B from passing the virus to their babies in Ethiopia. Researchers tested 387 babies born to hepatitis B-positive, HIV-negative mothers at 6-12 months of age. Overall, 5.2% of babies were infected. No infections were found in babies who received the birth dose, either alone or with hepatitis B immunoglobulin (HBIg), while 15.3% of babies with no protection at birth were infected. The authors conclude that the current schedule starting at 6 weeks is not enough and that a timely birth dose should be scaled up in Africa.
Key points
- Overall mother-to-child transmission risk was 5.2% (95% CI 3.4-7.8).
- Transmission was 0% (0/39) with the birth dose alone, compared with 15.3% (20/131) with no protection at birth (p = 0.009).
- No transmission occurred with the birth dose plus HBIg (0/217).
- Among infants without protection at birth, maternal viral load above 200,000 IU/ml (AOR 16.6) and HBeAg positivity (AOR 4.21) were linked to higher transmission risk.
- The authors state that the current vaccination series starting at 6 weeks is insufficient to prevent transmission.
Limitations
The abstract describes an observational cross-sectional study, not a randomised trial, so differences between groups may be due to factors other than the vaccine. The birth-dose-alone group was small (39 infants), so its confidence interval is wide (0-9.0%).
Abstract
BACKGROUND: Mother-to-child transmission (MTCT) is an important route of new hepatitis B virus (HBV) infections. In Africa, limited and conflicting data on the effectiveness of hepatitis B birth dose vaccination (HepB-BD) have contributed to fragmented adoption and sub-optimal implementation. We aimed to assess the effectiveness of timely HepB-BD in preventing HBV MTCT in Ethiopia. METHODS: We conducted a multi-centre cross-sectional observational study in Ethiopia from May 2022 to June 2024. We identified mothers who had tested positive for hepatitis B surface antigen (HBsAg) during pregnancy and assessed mother-infant pairs at 6-12 months post-partum for HBV MTCT. We stratified effectiveness of HepB-BD by maternal risk profile (HBV DNA level, hepatitis B e-antigen (HBeAg) status). RESULTS: The analysis included 387 children born to HBV-positive, HIV-negative mothers who had completed routine HBV vaccination (HepB3). The median age of infant testing was 10 months (IQR 7.0-11). Overall MTCT risk was 5.2% (95% CI 3.4,7.8). MTCT was significantly lower among infants receiving HepB-BD alone (0/39, 0% [95% CI 0-9.0]) compared to those without immunoprophylaxis at birth (20/131, 15.3% [95% CI 10.1-22.4]) (p = 0.009). No transmission occurred with HepB-BD plus HBIg (0/217, 0% [95% CI 0-1.7]). Maternal viral load >200,000 IU/ml (AOR 16.6, 95% CI 4.82,57.19) and HBeAg positivity (AOR 4.21, 95% CI 1.08,16.44) were associated with increased MTCT risk amongst infants without immunoprophylaxis at birth. CONCLUSIONS: In Ethiopia, the current vaccination series starting at 6 weeks is insufficient to prevent HBV MTCT. Timely HepB-BD is highly effective in reducing HBV MTCT and should be prioritised for scale-up in Africa.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Timely hepatitis B birth dose vaccination (HepB-BD), alone or with hepatitis B immunoglobulin (HBIg), compared with no immunoprophylaxis at birth
- Population
- 387 children born to HBV-positive, HIV-negative mothers in Ethiopia who had completed routine HepB3 vaccination, tested at a median age of 10 months
Key finding
Birth dose alone: 0/39 infants infected (0%, 95% CI 0-9.0) versus 20/131 (15.3%, 95% CI 10.1-22.4) with no protection at birth (p = 0.009)
Berhe et al. · OpenAlex · 23 Sept 2026