pediatrics
Neonatal Hepatitis B Virus (HBV) Infection
Key Points
Only hepatitis B virus (HBV) is a major cause of viral neonatal hepatitis; it is typically transmitted during delivery. Most neonates are asymptomatic but develop chronic, subclinical HBsAg antigenemia and elevated transaminase levels. Some infants develop mild hepatitis, and a few have fulminant liver disease. Do serologic testing of infant and mother. Neonates whose mothers are HBsAg-positive should be given 1 dose of HBIG 0.5 mL IM and HBV vaccine within 12 hours of birth. HBV-infected children should be immunized withhepatitis A vaccine; anti-HBV drugs (eg, interferon alfa) may help but should be used only in consultation with a pediatric hepatologist. 