{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T17:44:43Z","timestamp":1772473483516,"version":"3.50.1"},"reference-count":40,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2021,7,19]],"date-time":"2021-07-19T00:00:00Z","timestamp":1626652800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>Italy was one of the first industrialized countries to implement a program of routine vaccination against hepatitis B virus (HBV) infection. However, currently, no HBV vaccine is administered at birth if the screened mother is HBsAg negative, whilst babies born to HBsAg positive mothers are given vaccine and hepatitis B immunoglobulin, within 12\u201324 post-delivery hours. A single center retrospective analysis of policies and practices to prevent mother-to-child transmission of HBV was carried out, to evaluate their adherence to HBV care guidelines. Paired maternal-infant medical records for consecutive live births, between January 2015 and December 2019, were reviewed at the AOU Citt\u00e0 della Salute e Scienza di Torino, where a total of 235\/35,506 babies (0.7%) were born to HBsAg positive mothers. Markers of active viral replication, i.e., HBV DNA level and\/or HBeAg, were reported in only 66\/235 (28%) of the mothers\u2019 medical records. All newborns had immunoprophylaxis at birth: 61% at &lt;12 h, 31% between 12 and 24 h, 7% between 24 and 36 h and 1% at &gt;36 h. In 2019, two cases of vertical HBV transmission occurred, despite timely immunoprophylaxis, as their mothers\u2019 viral load was detected too late for antiviral prophylaxis. Missed early identification of pregnant women with high viremia levels or late vaccinations may contribute to perinatal HBV infection. Immunoprophylaxis should be given to babies born to HBsAg positive mothers at the latest within 12 h. In Italy, policies aimed at achieving the WHO 2030 goal of eliminating viral hepatitis should be further implemented.<\/jats:p>","DOI":"10.3390\/vaccines9070801","type":"journal-article","created":{"date-parts":[[2021,7,19]],"date-time":"2021-07-19T10:07:37Z","timestamp":1626689257000},"page":"801","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Timely Birth Dose Vaccine to Prevent Vertical Transmission of Hepatitis B: A Single Center Experience on the Road to the WHO Elimination Goals in Italy"],"prefix":"10.3390","volume":"9","author":[{"given":"Michele","family":"Pinon","sequence":"first","affiliation":[{"name":"Pediatric Gastroenterology Unit, AOU Citt\u00e0 della Salute e della Scienza di Torino, University of Turin, 10126 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6073-6608","authenticated-orcid":false,"given":"Laura","family":"Giugliano","sequence":"additional","affiliation":[{"name":"Pediatric Gastroenterology Unit, AOU Citt\u00e0 della Salute e della Scienza di Torino, University of Turin, 10126 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4518-9375","authenticated-orcid":false,"given":"Emanuele","family":"Nicastro","sequence":"additional","affiliation":[{"name":"Paediatric Hepatology, Gastroenterology and Transplantation, ASST Ospedale Papa Giovanni XXIII, 24127 Bergamo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9118-3604","authenticated-orcid":false,"given":"Omar","family":"Kakaa","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Public Health Sciences, University of Turin, 10126 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandra","family":"Coscia","sequence":"additional","affiliation":[{"name":"Neonatology Unit, AOU Citt\u00e0 della Salute e della Scienza di Torino, University of Turin, 10126 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caterina","family":"Carbonara","sequence":"additional","affiliation":[{"name":"Neonatology Unit, AOU Citt\u00e0 della Salute e della Scienza di Torino, University of Turin, 10126 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7150-3148","authenticated-orcid":false,"given":"Lorenzo","family":"D\u2019Antiga","sequence":"additional","affiliation":[{"name":"Paediatric Hepatology, Gastroenterology and Transplantation, ASST Ospedale Papa Giovanni XXIII, 24127 Bergamo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pier Luigi","family":"Calvo","sequence":"additional","affiliation":[{"name":"Pediatric Gastroenterology Unit, AOU Citt\u00e0 della Salute e della Scienza di Torino, University of Turin, 10126 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,7,19]]},"reference":[{"key":"ref_1","first-page":"1","article-title":"Recommendations for identification and public health management of persons with chronic hepatitis B virus infection","volume":"57","author":"Weinbaum","year":"2008","journal-title":"MMWR Recomm. Rep."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.15585\/mmwr.rr6701a1","article-title":"Prevention of Hepatitis B Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices","volume":"67","author":"Schillie","year":"2018","journal-title":"MMWR Recomm. Rep."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1002\/cld.728","article-title":"Update on Prevention, Diagnosis, and Treatment of Chronic Hepatitis B: AASLD 2018 Hepatitis B Guidance","volume":"12","author":"Terrault","year":"2018","journal-title":"Clin. Liver Dis."},{"key":"ref_4","unstructured":"(2021, January 24). LEGGE 27 maggio 1991, n. 165 Obbligatorieta\u2019 della Vaccinazione Contro L\u2019epatite Virale B. (GU Serie Generale n.127 del 01-06-1991). Available online: https:\/\/www.gazzettaufficiale.it\/eli\/id\/1991\/06\/01\/091G0201\/sg#:~:text=note%3A%20Entrata%20in%20vigore%20della%20legge%3A%2016%2F6%2F1991&text=1.-,1.,nel%20primo%20anno%20di%20vita."},{"key":"ref_5","unstructured":"Linea Guida Gravidanza Fisiologica (2021, January 24). Sistema Nazionale per le linee Guida Istituto Superiore di Sanit\u00e0 (SNLG-ISS), Aggiornamento, Available online: http:\/\/www.salute.gov.it\/imgs\/C_17_pubblicazioni_1436_allegato.pdf."},{"key":"ref_6","unstructured":"(2021, January 24). Piano Nazionale Prevenzione Vaccinale PNPV 2017-2019. G.U. Serie Generale, n. 41 del 18 Febbraio 2017. Available online: https:\/\/www.gazzettaufficiale.it\/eli\/gu\/2017\/02\/18\/41\/sg\/pdf."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"750","DOI":"10.5812\/kowsar.1735143X.663","article-title":"Epidemiological impact of mandatory vaccination against hepatitis B in Italian young adults","volume":"11","author":"Campagna","year":"2011","journal-title":"Hepat. Mon."},{"key":"ref_8","unstructured":"Sistema Epidemiologico Integrato dell\u2019Epatite Virale Acuta (SEIEVA) (2020, March 24). Istituto Superiore di Sanit\u00e0. Bollettino Annuale 2019. Available online: http:\/\/www.iss.it\/seieva."},{"key":"ref_9","unstructured":"(2021, January 24). 2015 Assessment Report of the Global Vaccine Action Plan, Available online: https:\/\/www.who.int\/immunization\/sage\/meetings\/2015\/october\/2_ARORA__GVAP_Assessment_recommendations_SAGE_Oct_2015_Final.pdf."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.4161\/hv.23827","article-title":"Economic analysis of the first 20 years of universal hepatitis B vaccination program in Italy: An a posteriori evaluation and forecast of future benefits","volume":"9","author":"Boccalini","year":"2013","journal-title":"Hum. Vaccines Immunother."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"786","DOI":"10.1002\/jmv.25027","article-title":"What is changed in HBV molecular epidemiology in Italy?","volume":"90","author":"Lai","year":"2018","journal-title":"J. Med. Virol."},{"key":"ref_12","unstructured":"(2021, January 09). Prevention of Mother-to-Child Transmission of Hepatitis B Virus: Guidelines on Antiviral Prophylaxis in Pregnancy, Available online: https:\/\/www.who.int\/publications\/i\/item\/978-92-4-000270-8."},{"key":"ref_13","unstructured":"Cornberg, M. (2021, January 09). Annex C: Hepatitis B Birth dose Investment Case. GAVI, Available online: https:\/\/www.gavi.org\/sites\/default\/files\/document\/ppc-meeting-18-19-october-2018---vis-06a---annex-c--hepatitis-b-birth-dose-investment-casepdf.pdf."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1329","DOI":"10.1093\/ije\/dyi206","article-title":"A mathematical model to estimate global hepatitis B disease burden and vaccination impact","volume":"34","author":"Goldstein","year":"2005","journal-title":"Int. J. Epidemiol."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"de Villiers, M.J., Gamkrelidze, I., Hallett, T.B., Nayagam, S., Razavi, H., and Razavi-Shearer, D. (2020). Modelling hepatitis B virus infection and impact of timely birth dose vaccine: A comparison of two simulation models. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0237525"},{"key":"ref_16","unstructured":"(2021, January 05). Global Hepatitis Report, Available online: http:\/\/apps.who.int\/iris\/bitstream\/10665\/255016\/1\/9789241565455-eng.pdf?ua=1."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"921","DOI":"10.1016\/S0140-6736(84)92388-2","article-title":"Prevention of the HBsAg carrier state in newborn infants of mothers who are chronic carriers of HBsAg and HBeAg by administration of hepatitis-B vaccine and hepatitis-B immunoglobulin. Double-blind randomised placebo-controlled study","volume":"1","author":"Wong","year":"1984","journal-title":"Lancet"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1093\/infdis\/152.4.817","article-title":"Immunoprophylaxis of infection with hepatitis B virus in infants born to hepatitis B surface antigen-positive carrier mothers","volume":"152","author":"Lo","year":"1985","journal-title":"J. Infect. Dis."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1016\/j.annepidem.2009.01.017","article-title":"Rocks along the road to the control of HBV and HCC","volume":"19","author":"Beasley","year":"2009","journal-title":"Ann. Epidemiol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1016\/S2468-1253(19)30042-1","article-title":"Hepatitis B virus infection in children and adolescents","volume":"4","author":"Indolfi","year":"2019","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"ref_21","unstructured":"(2021, January 23). Guidelines for the Prevention, Care and Treatment of Persons with Chronic Hepatitis B Infection, Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK305553\/."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"European Association for the Study of the Liver (2017). EASL 2017 Clinical Practice Guidelines on the management of hepatitis B virus infection. J. Hepatol., 67, 370\u2013398.","DOI":"10.1016\/j.jhep.2017.03.021"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1002\/hep.28156","article-title":"AASLD guidelines for treatment of chronic hepatitis B","volume":"63","author":"Terrault","year":"2016","journal-title":"Hepatology"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"911","DOI":"10.1056\/NEJMoa1708131","article-title":"Tenofovir versus Placebo to Prevent Perinatal Transmission of Hepatitis B","volume":"378","author":"Jourdain","year":"2018","journal-title":"N. Engl. J. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"704","DOI":"10.1542\/peds.2009-1831","article-title":"Gaps in hospital policies and practices to prevent perinatal transmission of hepatitis B virus","volume":"125","author":"Willis","year":"2010","journal-title":"Pediatrics"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"9303","DOI":"10.1016\/j.vaccine.2011.10.028","article-title":"Universal screening for hepatitis B among pregnant women led to 96% vaccination coverage among newborns of HBsAg positive mothers in Denmark","volume":"29","author":"Harder","year":"2011","journal-title":"Vaccine"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e4390","DOI":"10.1097\/MD.0000000000004390","article-title":"Protective effect of an improved immunization practice of mother-to-infant transmission of hepatitis B virus and risk factors associated with immunoprophylaxis failure","volume":"95","author":"Wang","year":"2016","journal-title":"Medicine"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"3362","DOI":"10.1016\/j.vaccine.2014.04.045","article-title":"Risk factors associated with immunoprophylaxis failure against mother to child transmission of hepatitis B virus and hepatitis B vaccination status in Yunnan province, China","volume":"32","author":"Kang","year":"2014","journal-title":"Vaccine"},{"key":"ref_29","first-page":"8998","article-title":"Hepatitis B virus: Where do we stand and what is the next step for eradication?","volume":"20","author":"Komatsu","year":"2014","journal-title":"World J. Gastroenterol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/j.vaccine.2012.10.079","article-title":"Using data to guide policy: Next steps for preventing perinatal hepatitis B virus transmission in Cambodia","volume":"31","author":"Soeung","year":"2012","journal-title":"Vaccine"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1367","DOI":"10.2105\/AJPH.2004.046284","article-title":"Timeliness of childhood immunizations: A state-specific analysis","volume":"95","author":"Luman","year":"2005","journal-title":"Am. J. Public Health"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1111\/jvh.13459","article-title":"Adherence to pregnancy hepatitis B care guidelines in women and infants in the U.S. and evaluation of two interventions to improve care: A multi-center hospital-based study","volume":"28","author":"Kushner","year":"2021","journal-title":"J. Viral Hepat."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1007\/s15010-012-0384-9","article-title":"Hepatitis B and immigrants: A SIMIT multicenter cross-sectional study","volume":"41","author":"Fasano","year":"2013","journal-title":"Infection"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"7635","DOI":"10.3748\/wjg.v20.i24.7635","article-title":"Epidemiology of acute and chronic hepatitis B and delta over the last 5 decades in Italy","volume":"20","author":"Sagnelli","year":"2014","journal-title":"World J. Gastroenterol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1186\/s40249-016-0228-4","article-title":"Hepatitis B virus infection in undocumented immigrants and refugees in Southern Italy: Demographic, virological, and clinical features","volume":"6","author":"Coppola","year":"2017","journal-title":"Infect. Dis. Poverty"},{"key":"ref_36","unstructured":"(2021, January 24). Global Alert and Response. Hepatitis B. Prevention and Treatment, Available online: http:\/\/www.who.int\/csr\/disease\/hepatitis\/whocdscsrlyo20022\/en\/index5.html."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1086\/323396","article-title":"Effectiveness of hepatitis B vaccination in babies born to hepatitis B surface antigen-positive mothers in Italy","volume":"184","author":"Mele","year":"2001","journal-title":"J. Infect. Dis."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1097\/MPG.0000000000003042","article-title":"Management of Hepatitis-B Virus Infection in Immunocompromised Children. A Single Center Experience","volume":"72","author":"Calvo","year":"2020","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1097\/MPG.0000000000002628","article-title":"Management of Hepatitis B Virus Infection and Prevention of Hepatitis B Virus Reactivation in Children With Acquired Immunodeficiencies or Undergoing Immune Suppressive, Cytotoxic, or Biological Modifier Therapies","volume":"70","author":"Indolfi","year":"2020","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_40","first-page":"10","article-title":"Hepatitis C Guidance 2019 Update: American Association for the study of the Liver Diseases-Infectious Disease Society of American recommendations for Testing, Managing and Treating Hepatitis C Virus Infection","volume":"71","author":"Ghany","year":"2020","journal-title":"AASLD\/IDSA Hepat. C Guid. Panel Hepatol."}],"container-title":["Vaccines"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-393X\/9\/7\/801\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:31:55Z","timestamp":1760164315000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-393X\/9\/7\/801"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,19]]},"references-count":40,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2021,7]]}},"alternative-id":["vaccines9070801"],"URL":"https:\/\/doi.org\/10.3390\/vaccines9070801","relation":{},"ISSN":["2076-393X"],"issn-type":[{"value":"2076-393X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7,19]]}}}