2025 Webinar – Mother-To-Child Transmission of HBV (ondemand)-MTCT Webinar

Video Transcription

Video Summary

This ASLD-sponsored webinar focused on mother-to-child transmission (MTCT) of hepatitis B, featuring expert insights from Drs. Calvin Pan and Bob Gish. Dr. Pan outlined the critical global burden, highlighting that about one-third of new chronic hepatitis B infections stem from MTCT, especially in endemic regions like Asia and Africa, totaling roughly 1 million new infections annually. He emphasized that reducing MTCT rates below 2%, as targeted by WHO, can drastically reduce hepatitis B prevalence, using China's model as an example.<br /><br />Current standard prevention involves newborn immunoprophylaxis with hepatitis B immunoglobulin (HBIG) and timely vaccination, ideally within 12 hours of birth. However, challenges exist in resource-limited settings, where such prompt administration is often not feasible, leading to higher transmission rates. Dr. Pan stressed the importance of antiviral prophylaxis during pregnancy, especially for mothers with high viral loads (>200,000 IU/mL), where immunoprophylaxis alone may fail. Tenofovir disoproxil fumarate (TDF) and tenofovir alafenamide (TAF) were presented as effective and safe antiviral options, with data supporting treatment initiated between 24–28 weeks gestation or earlier for very high viral loads, reducing MTCT rates below 2%.<br /><br />The webinar also addressed practical considerations such as universal maternal screening, the potential for HBIG-free regimens (increasing feasibility in low-resource settings), safety of antivirals during pregnancy and breastfeeding, and the importance of global policy and implementation strategies. Discussions included the difficulties in vaccine delivery timing, vaccine storage concerns, and the balance between universal birth dose vaccination versus targeted approaches. The experts underscored the need for simplified programs to avoid gaps in care and advocated for comprehensive approaches combining screening, antiviral prophylaxis, and timely infant immunization to move toward global elimination of MTCT of hepatitis B.

Keywords

mother-to-child transmission

hepatitis B

ASLD webinar

Dr. Calvin Pan

Dr. Bob Gish

global burden

immunoprophylaxis

antiviral prophylaxis

tenofovir disoproxil fumarate

tenofovir alafenamide

universal maternal screening