HEPATITIS Sreening of pregnant women for hepatitis B markers in a French Provincial University Hospital (Limoges) during 15 years Franc¸ois Denis 1 , Sylvie Ranger-Rogez 1 , Sophie Alain 1 , Marcelle Mounier 1 , Caroline Debrock 1 , Anne Wagner 1 , Christian Delpeyroux 1 , Jean Louis Tabaste 2 , Yves Aubard 2 & Pierre-Marie Preux 3 1 Department of Bacteriology, Virology and Hygiene; 2 Gynecology and Obstetric; 3 UF Recherche clinique et Biostatistique, University Hospital Limoges, France Accepted in revised form 7 April 2004 Abstract. During the 15 years from January 1984 to December 1998 the Limoges University Hospital screened 22,859 pregnant patients for hepatitis B surface antigen (HBs Ag) and identified 149 posi- tives. The overall prevalence (0.65%) was interme- diate between prevalences observed among women of French origin (0.29%), French West Indies islands (5.68%) and of foreign origin particulary South East Asian origin (7.14%) and Sub Saharan African origin (6.52%). Hepatitis B Virus (HBV) replication markers was detected with relative low frequence (HBe Ag: 14.4%; HBV-DNA: 13.7–20%) among HBs Ag positive mothers. Markers of delta hepatitis virus was found among 10.5% of the HBs Ag carrier pregnant women. During the 15 years study period variations of the global prevalence were not statistically significant. Universal prenatal screening and infant immunisation could greatly contribute to the control of HBV infection if the polemic about the hepatitis B vaccination recently propagated in France will not have a negative effect on the acceptance and national programme of vaccination. Key words: HBs Ag carrier, Hepatitis B virus, Hepatitis B vaccine, Infant, Mothers Abbreviations: HBV = hepatitis B virus; HBs Ag = hepatitis B surface antigen; HBV-DNA = ADN of hepatitis B virus; HBe Ag= hepatitis B ‘‘e’’ antigen; anti HBe Ag = hepatitis B ‘‘e’’ antibody; HBIG = hepatitis B immune globulin Introduction Without medical intervention, hepatitis B virus (HBV) is transmitted from an infected pregnant wo- man to her infant in between 10 and 90% of cases at the time of parturition, depending upon whether the mother is negative or positive for replication markers. As many as 90% of these will progress to the chronic carrier state with a certain percentage (about 25%) at risk of a fatal evolution of their chronic liver diseases towards cirrhosis and hepatocarcinoma [1]. From the 1980s, several countries have recommended universal testing of pregnant women for hepatitis B surface antigen (HBs Ag) and prevention of virus transmis- sion to their offspring by using hepatitis B immune globulin (HBIG) and vaccine in all babies born to HBs Ag positive mothers [2–12]. At the Limoges University hospital, we started testing in January 1984, many years before the national French recommendations made in March 1992. This study was organised to analyse the data of 15 years of screening pregnant women, particularly demographic characteristics of those tested (HBs Ag positive and negative) and the annual prevalence and fluctuation of replication HBV markers among HBs Ag positive expectant mothers. Subjects and methods Laboratory tests During 15 years (1984–1998) routine prenatal blood samples of all pregnant women followed in gynecology–obstetrics departments were tested in the Virology laboratories of the Limoges University Hos- pital for HBs Ag (Auszyme or HBS Ag IMX or HBs Ag Axym, Abbott Laboratories, North Chicago, IL, USA). All HBs Ag positive results were confirmed by a neutralisation antibody test from Abbott and tested to detect HBe Ag and anti-HBe (HBe Abbott Laborato- ries) and to look for HBV-DNA (Genostix, Abbott Laboratories or HBV-DNA Assay. Digene Hybrid Capture System. Murex Diagnostics S.A., Chatillon, France). European Journal of Epidemiology 19: 973–978, 2004. Ó 2004 Kluwer Academic Publishers. Printed in the Netherlands.