Universal HBV immunization programme for newborns in HK has started since 1988. The programme consists of administration of HB immunoglobulins (Ig) to babies born to HBsAg+ve mothers together with the 1st dose of HBV vaccine upon delivery. The 2nd & 3rd doses of HBV vaccines will be given mainly in the Maternal & Child Health Centres (MCHC) at 1 and 6 months respectively. Notably, the proportion of HBsAg+ve pregnant women is decreasing from 5.2% (2016), 5.0% (2017), 4.5% (2018) to 4.0% (2019). However, despite a 99.8% HBsAg screening coverage for antenatal women, together with a 99.5% coverage with HBIg and HBV vaccinations for livebirths born to HBsAg+ve mothers, the overall MTCT rate was still 1.1% (immunoprophylaxis failure, IF) from a local study of 641 HBsAg+ve pregnant women. In order to achieve the World Health Organization (WHO) vision to eliminate viral hepatitis as a public health threat by 2030, more specific, the WHO target of 200,000 IU/ml (estimated IF rate 4.2%) will be given an early referral to the corresponding HA Hepatology Clinic to discuss starting Tenofovir by 28 weeks gestation to further reduce the risk of MTCT of HBV. This programme has started as a pilot in QMH & PWH since 1Q 2020 and extended to PYNEH, KWH, QEH, PMH, UCH & TMH since 3Q 2020. About 600 HBsAg+ve pregnant women are recruited, 17% of them having high HBV viral load > 200,000 IU/ml. After seen by Hepatologists, 81% of them have started taking Tenofovir. One important aspect for outcome assessment to be highlighted is that post-vaccination serology testing (PVST) will be performed to infants after completing the full course of vaccination.
