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Hepatitis B Virus (HBV) Infection in Newborns


Brenda L. Tesini

, MD, University of Rochester School of Medicine and Dentistry

Last full review/revision Jul 2020| Content last modified Jul 2020

Hepatitis B virus infection causes inflammation of the liver.

  • Newborns may become infected at birth or rarely after birth.
  • Newborns who develop symptoms have jaundice, lethargy, and failure to thrive.
  • The diagnosis is typically based on blood tests.
  • Children are at risk of liver problems later in life.
  • The hepatitis B vaccine and sometimes hepatitis B immune globulin are given to newborns to protect them against the infection.

(See also Overview of Infections in Newborns and Overview of Hepatitis.)

Hepatitis B is a type of hepatitis virus newborns can contract and is a cause of great concern in newborns.

The infection occurs during delivery if the mother is infected. However, newborns may become infected after birth from other sources, such as the mother's saliva, stool, urine, or breast milk.

Symptoms of HBV Infection in Newborns

Most newborns who have hepatitis B virus (HBV) infection have no symptoms at birth but continue to carry the infection in their bodies.

Many newborns born to women who have acute hepatitis B during pregnancy have a low birth weight, regardless of whether they are infected.

Infrequently, infected newborns develop acute hepatitis B, which is usually mild and goes away without treatment. They develop jaundice (a yellow color of the skin or eyes), lethargy, failure to thrive, a swollen abdomen, and clay-colored stools. Rarely, the infection is severe and causes death.

Chronic liver disease (such as chronic hepatitis or cirrhosis) may develop but usually does not cause symptoms until young adulthood.

Diagnosis of HBV Infection in Newborns

  • Blood tests

Doctors do blood tests to look for the hepatitis B virus as well as antibodies to the virus. Doctors also do blood tests to determine whether a liver disease has developed (see Liver Blood Tests).

Ultrasonography is done to provide images of the liver.

Prognosis of HBV Infection in Newborns

Although the long-term prognosis for chronic hepatitis B virus infection cannot be predicted, it is known that chronic infection early in life increases the risk of later liver disease including chronic hepatitis, cirrhosis, end-stage liver disease requiring transplantation, and liver cancer.

Treatment and Prevention

  • Treatment of symptoms and good nutrition
  • Vaccination
  • Sometimes immune globulin

Doctors treat the problems caused by hepatitis B virus infection. It is especially important for affected newborns to receive good nutrition.

All newborns, whether or not infected, are given the first dose of the hepatitis B virus vaccine before they are discharged from the hospital.

Newborns born to an infected mother are also given hepatitis B immune globulin, a preparation of antibodies against hepatitis B. The first dose of the vaccine and the immune globulin are given within 12 hours of birth.

Drugs Mentioned In This Article

Generic Name Select Brand Names
immune globulin Gammagard S/D

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