Current through Bulletin 2024-06, March 15, 2024
(1) A licensed
healthcare provider who provides prenatal care shall routinely test each
pregnant woman for hepatitis B surface antigen (HBsAg) at an early prenatal
care visit. This section does not apply if the pregnant woman, after being
informed of the possible consequences, objects to the test on the basis of
religious or personal beliefs.
(2)
The licensed healthcare provider who provides prenatal care shall repeat the
HBsAg test during late pregnancy for those women who tested negative for HBsAg
during early pregnancy, but who are at high risk based on:
(a) evidence of clinical hepatitis during
pregnancy;
(b) injection drug
use;
(c) occurrence during
pregnancy or a history of a sexually transmitted disease;
(d) occurrence of hepatitis B in a household
or close family contact; or
(e) the
judgment of the healthcare provider.
(3) In addition to other reporting required
by this rule, each positive HBsAg result detected in a pregnant woman shall be
reported to the local health department or the Department, as specified in
Section 26-6-6. That report shall indicate
that the woman was pregnant at time of testing if that information is available
to the reporting entity.
(4) A
licensed healthcare provider who provides prenatal care shall document a
woman's HBsAg test results, or the basis of the objection to the test, in the
medical record for that patient.
(5) Every hospital and birthing facility
shall develop a policy to assure that:
(a)
when a pregnant woman is admitted for delivery, or for monitoring of pregnancy
status, the result from a test for HBsAg performed on that woman during that
pregnancy is available for review and documented in the hospital
record;
(b) when a pregnant woman
is admitted for delivery, if the woman's test result is not available to the
hospital or birthing facility, the mother is tested for HBsAg as soon as
possible, but before discharge from the hospital or birthing
facility;
(c) if a pregnant woman
who has not had prenatal care during that pregnancy is admitted for monitoring
of pregnancy status only, and if the woman's test result is not available to
the hospital or birthing facility, the mother is tested for HBsAg status before
discharge from the hospital or birthing facility;
(d) positive HBsAg results identified by
testing performed or documented during the hospital stay are reported as
specified in this rule;
(e) infants
born to HBsAg positive mothers receive hepatitis B immune globulin (HBIG) and
hepatitis B vaccine, administered at separate injection sites, within 12 hours
of birth;
(f) infants born to
mothers whose HBsAg status is unknown receive hepatitis B vaccine within 12
hours of birth, and if the infant is born preterm with birth weight less than
2,000 grams, that infant also receives HBIG within 12 hours;
(g) if at the time of birth the mother's
HBsAg status is unknown and the HBsAg test result is later determined to be
positive, that infant receives HBIG as soon as possible but within 7 days of
birth; and
(h) hepatitis B immune
globulin administration and birth dose hepatitis B vaccine status of infants
born to mothers who are HBsAg positive are reported within 24 hours of delivery
to the local health department and Utah Department of Health and Human Services
Immunization Program at (801) 538-9450.
(6) Local health departments shall perform
the following activities or assure that they are performed:
(a) Females between the ages of 12 and 50
years when an HBsAg positive test result is reported will be screened for
pregnancy status within one week of receipt of that lab result.
(b) Infants born to HBsAg positive mothers
complete the hepatitis B vaccine series as specified in the "Red Book:
2021-2024 Report of the Committee on Infectious Diseases" 32nd Edition. Elk
Grove Village, IL, American Academy of Pediatrics; 2021.
(c) Children born to HBsAg positive mothers
are tested for HBsAg and antibody against hepatitis B surface antigen
(anti-HBs) at 9 to 12 months of age to monitor the success of therapy and
identify cases of perinatal hepatitis B infection. Testing is done at least one
month after the final dose of hepatitis B vaccine series is administered, and
no earlier than 9 months of age. Children who test negative for HBsAg and do
not demonstrate serological evidence of immunity against hepatitis B when
tested as described in this subsection receive three additional vaccine doses
and are retested as specified in the "Red Book: 2021-2024 Report of the
Committee on Infectious Diseases" 32nd Edition. Elk Grove Village, IL, American
Academy of Pediatrics; 2021.
(d)
HBsAg positive mothers are advised regarding how to reduce their risk of
transmitting hepatitis B to others.
(e) Household members and sex partners of
HBsAg positive mothers are evaluated to determine susceptibility to hepatitis B
infection and if determined to be susceptible, are offered or advised to obtain
vaccination against hepatitis B. Identified acute hepatitis B cases shall be
investigated by the local health department, and identified household and
sexual contacts shall be advised to obtain vaccination against hepatitis
B.
(7) Subsections (5)
and (6) do not apply if the pregnant woman or the child's guardian, after being
informed of the possible consequences, objects to any of the required
procedures on the basis of religious or moral beliefs. The hospital or birthing
facility shall document the basis of the objection.
(8) Prevention of transmission by individuals
with chronic hepatitis B infection.
(a) The
Department defines a chronic hepatitis B case as a person that is HBsAg
positive, total antibody against hepatitis B core antigen (anti-HBc) positive,
if performed, and IgM anti-HBc negative.
(b) An individual with chronic hepatitis B
infection shall be advised regarding how to reduce the risk that the individual
will transmit hepatitis B to others.
(c) Household members and sex partners of
individuals with chronic hepatitis B infection shall be evaluated to determine
susceptibility to hepatitis B infection, and if determined to be susceptible,
shall be offered or advised to obtain vaccination against Hepatitis
B.