Efficacy of Selective Antenatal Screening for Hepatitis B Among Pregnant Women in Denmark: Is Selective Screening Still an Acceptable Strategy in a Low-endemicity Country?

Abstract

The prevalence of hepatitis B virus (HBV) carriage in Denmark is unknown, but expected to be low (0.1%). This study aimed to evaluate the efficacy of selective antenatal screening for HBV infection and the epidemiology of HBV and hepatitis C virus (HCV) among pregnant women. 4098 women were included in the study. Blood tests were examined for hepatitis B surface antigen (HB_sAg), anti-hepatitis B core antigen (HB_c) and anti-HCV. Case records were studied to evaluate whether patients at risk for HBV infection had been tested. Among the 4098 women, 18 [0.4%, 95% confidence interval (95% CI) 0.3-0.7] were HB_sAg positive. All had a risk factor for HBV infection. Only 13 (72%) were identified as HB_sAg positive in the selective screening programme. 115 women (2.8%, 95% CI 2.3-3.4) were anti-HB_c positive only. 95 (83%) were at risk for HBV. Only 72 of these (63%) were tested for HB_sAg. The screening programme in this area of Denmark did not pick up one-third of pregnant women at risk of HBV.