PA.43 Maternal Hepatitis B – does an integrated care pathway help in achieving complete immunisation schedule in babies?

Introduction Timely and complete immunisation in babies born to hepatitis B chronic carrier mothers can prevent transmission by up to 90%. 1 Managing these babies by integrated care pathway can be effective in improving clinical care. Objective To assess the immunisation outcome in babies born to hepatitis B carrier mothers managed by an integrated care pathway. Methods A retrospective case review of babies born to hepatitis B carrier mothers was carried out from July 2008 to March 2011 to collect data on the serology and immunisations. The same antenatal screening midwife, community nurse and neonatologist did all follow up as per care pathway agreed between primary and tertiary care. 2 nd and subsequent immunisations were given at home. Results 73 Women were hepatitis B surface antigen positive. 55 were black African, Chinese or Asian origin (78%). 72 babies (98.6%) had 1 st hepatitis B vaccine dose within 24 h after birth and 2nd dose at 1 month. 69 (94.5%) babies had 3 rd dose at 2 months and 60 (82.2%) babies had 4 th dose at 12 months. 56 babies had negative hepatitis B surface antigen and had positive anti-HBsAg antibodies after 4 th dose. 13 babies may not have received 4 th dose of vaccine – 7 moved out of the UK, 3 moved out of local area, 3 were untraceable. Conclusion Black and Minority populations are at high risk of having hepatitis B infection in Coventry. An integrated care pathway for hepatitis B positive mothers and their babies helps to improve vaccine uptake and reduce non-compliance.