Trends in clinical intervention practice for preventing mother-to-child transmission of hepatitis B virus in Guangdong Province, 2021–2023

Guangdong Province in China is endemic for hepatitis B virus (HBV) infection with a high prevalence of chronic HBV infection in pregnant women. Measures have been taken to reduce mother-to-child transmission (MTCT) of HBV. This study aims to analyze the trends in these preventive measures in hepatitis B surface antigen (HBsAg)-positive pregnant women from 2021 to 2023. Data were obtained from the case report forms of HBsAg-positive pregnant women and their newborns that were completed and reported in Guangdong Province through the Information System of the National Integrated Prevention of Mother-to-Child Transmission of HIV, syphilis and hepatitis B Programme from January 1, 2021, to December 31, 2023. The Cochran-Armitage test was employed to analyze trends in maternal hepatitis B e antigen (HBeAg) positivity rates across different age groups of pregnant women, antiviral treatment rates in the total and HBeAg-positive populations, and the coverage of timely birth dose of the hepatitis B vaccine (HepB-BD) and hepatitis B immunoglobulin (HBIG) among infants born to the total and HBeAg-positive pregnant women from 2021 to 2023. A total of 283,959 HBsAg-positive pregnant women and their newborns were included in the study. The HBeAg positivity rate among the HBsAg-positive pregnant women was 26.1%. The prevalence of HBeAg positivity among HBsAg-positive pregnant women in Guangdong Province experienced a declining trend from 2021 to 2023. Over the same period, the uptake of antiviral treatment increased in both the overall population and the HBeAg-positive subgroup, with the proportion of HBeAg-positive pregnant women receiving antiviral therapy rising from 23.8% in 2021 to 51.8% in 2023. The proportion of HBV-exposed newborns receiving both HepB-BD and HBIG within 12 hours of birth also increased steadily, with coverage exceeding 97% in 2023. This study highlights significant progress in reducing MTCT of hepatitis B in Guangdong Province from 2021 to 2023. HBeAg positivity among HBsAg-positive pregnant women declined, while both the uptake of antiviral therapy and the timely administration of HepB-BD and HBIG to HBV-exposed infants improved markedly. These findings underscore the important role of public health interventions while emphasizing the need for sustained efforts, particularly for young HBeAg-positive pregnant women.