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Hepatitis B — SCE Infectious Diseases MCQ

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HardHepatitisHepatitis BSCE Infectious Diseases

A pregnant woman is HBsAg positive and has HBV DNA 3.0×10^7 IU/mL. Which intervention specifically addresses residual vertical-transmission risk despite planned infant vaccination?

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Correct answer: E — Start maternal tenofovir disoproxil prophylaxis in late pregnancy and still provide prompt infant hepatitis-B immunoprophylaxis after review

The best answer is “Start maternal tenofovir disoproxil prophylaxis in late pregnancy and still provide prompt infant hepatitis-B immunoprophylaxis after review”. Maternal viraemia is far above the prophylaxis threshold; tenofovir lowers intrapartum exposure while infant vaccine-based prophylaxis remains essential. “Use maternal entecavir only during labour and omit infant vaccine” is less appropriate because it does not satisfy the scenario's decisive clinical or jurisdictional requirement. “Schedule caesarean birth as a substitute for antiviral prophylaxis” is less appropriate because it does not satisfy the scenario's decisive clinical or jurisdictional requirement. “Give hepatitis-B immunoglobulin to the mother rather than the infant” is less appropriate because it does not satisfy the scenario's decisive clinical or jurisdictional requirement. “Wait for maternal alanine aminotransferase elevation before preventing transmission” is less appropriate because it does not satisfy the scenario's decisive clinical or jurisdictional requirement.

Reference: WHO prevention of mother-to-child transmission of hepatitis B: https://www.who.int/publications/i/item/978-92-4-000270-8