Viral Hepatitis B Infected Pregnant Female

Reportable by Laboratories and Providers

About this Reportable Disease

Infectious agent: Hepatitis B virus

Description of illness: Hepatitis B virus (HBV) infection in a pregnant woman poses a serious risk to her infant at birth. Without post-exposure prophylaxis, approximately 40% of infants born to HBV-infected mothers in the United States will develop chronic HBV infection, approximately one-fourth of whom will eventually die from chronic liver disease. Administering post-exposure prophylaxis (PEP) of hepatitis B immune globulin (HBIG) and a dose of hepatitis B vaccine within 12 hours of life is 85%–95% effective in preventing mother-to-child transmission of HBV. For this reason, reporting is required for each incidence of pregnancy, even if the woman is already known to be chronically infected.

Interactive Disease Data


Laboratory Reporting for this Disease

Hepatitis B

TEST NAME Hepatitis B 
DISEASE/DISORDER Hepatitis B 
ALTERNATE NAME(S) Hep B, HBV, HBsAg, HBsAb, anti-HB(s)
METHODOLOGY Chemiluminescent Microparticle Immunoassay (CMIA) on the Abbott Architect Analyzer 
SPECIAL INSTRUCTIONS

Hepatitis B Panel includes HBV surface antibody, surface antigen, and total Core antibodies.
ORDERING INFORMATION

Lab Web Portal

PTBMIS:

- Test Order Code: HEPB
- Test Order Description: Hepatitis B Pan

Specimen Requirements

Patient Preparation
  • Venipuncture
Specimen Collection
  • Acceptable Specimen Sources/Type(s)

 - Whole blood in serum separator tube (SST)

- Whole blood in serum coagulation tube (red top)
Specimen Labeling
  • Specimen must be labeled with at least two unique patient identifiers and match accompanying test order.
Specimen Processing
  • Specimens should be centrifuged 1837 RCF (g) for 12 minutes.
Specimen Storage and Preservation
  • Specimens may be stored on or off the clot, red blood cells, or separator gel for ≤ three (3) days for specimens stored 21 to 22°C or up to six (6) days for specimens stored at 2 to 8°C. 
  • If testing will be delayed more than six (6) days for specimens stored at 2 to 8°C, aliquot serum into a sterile, plastic, screw-capped vial and store at ≤ -20°C. 
  • Avoid more than three (3) freeze/thaw cycle
Specimen Transport
  • Ship specimens at 2 to 8°C on cold packs. 
  • Specimen must be placed in a biohazard bag with absorbent material and should be shipped to the laboratory on the day of collection, if possible. 
  • All infectious substance shipments must conform to U.S. Department of Transportation (DOT) Hazardous Materials Regulations (HMR 49 C.F.R. Parts 171-180). 
Specimen Acceptability and Rejection
  • Serum specimens collected in serum coagulation (red top) tubes or serum separator tubes will be accepted.
  • Grossly hemolyzed, lipemic, or microbially contaminated specimens will be rejected.
  • Cadaveric specimens will be rejected.
  • Specimens with clerical errors in the lab order or on the specimen tube will be rejected.
  • Specimens broken in transit will be rejected. 
  • Specimens leaking in transit may be rejected after assessment of viability and contamination. 
  • Specimens with insufficient volumes of serum will be rejected. 
  • Specimens transported or stored at incorrect temperatures will be rejected.
  • Specimens received after expiration of viability will be rejected.
  • Unlabeled or improperly identified specimens will be rejected.
Testing Location
  • Nashville
  • Knoxville

Laboratory Reporting

Reporting requirements apply to all laboratories located within Tennessee, as well as laboratories outside of Tennessee that test residents of Tennessee, including laboratories located within healthcare facilities. Healthcare providers and laboratories in the same healthcare facility both have a duty to report. The type of organisms and analytes laboratories must report to TDH for 2026 are indicated, and there are several ways laboratories can report results to TDH.

Information about this Reportable Disease for Healthcare Providers

Clinical Summary

  • Hepatitis B virus (HBV) infection during pregnancy is a major concern because transmission can occur at delivery, and infection acquired in infancy is more likely to become chronic and lead to serious liver disease later in life. 
  • Care begins with prenatal identification and coordination. CDC emphasizes confirming infection (e.g., hepatitis B surface antigen [HBsAg] positive) and ensuring the pregnant patient is connected to perinatal hepatitis B prevention case management so the infant’s prophylaxis and follow-up are not missed. 
  • Newborn prophylaxis must happen immediately. For infants born to an HBsAg-positive parent, CDC recommends hepatitis B vaccine and hepatitis B immune globulin (HBIG) as soon as possible after birth (and Tennessee resources emphasize within 12 hours) to prevent perinatal transmission. 
  • Reporting and infant follow-up are required to protect the baby. Tennessee classifies perinatal HBV infection as reportable and requires reporting for each pregnancy involving an HBV-infected pregnant patient; CDC also describes ongoing infant follow-up (including completion of the vaccine series and post-vaccination testing) through perinatal hepatitis B prevention programs.

Healthcare Provider Reporting

Healthcare reporting requirements apply to all providers located within Tennessee, as well as providers whose patients reside in Tennessee.

Providers must report cases of all diseases and conditions listed through one of these methods:

• Mail or fax a completed PH-1600 form to your local health department or fax to the state health office at (615) 741-3857

• Send automatically via electronic case reporting (eCR). See this TDH webpage for more information on eCR, register at the Trader Partner Registration website, or contact MU.Health@tn.gov for assistance.

• Submit online via NBS. NBS is TDH's reportable disease system. To request an NBS account for reporting Complete this user survey to request an NBS account for reporting. 

• Blood lead levels can be sent via fax ( (615) 741-3857), entered online, or reported using the instructions at this link. 

Information about this Reportable Disease for the Public

What It Is?

Hepatitis B is a liver infection caused by the hepatitis B virus (HBV). If a pregnant woman has HBV, the virus can be passed to the baby, most often at delivery. Babies who become infected are much more likely to develop chronic (lifelong) HBV infection, which can later lead to serious liver disease, including cirrhosis or liver cancer.

How Hepatitis B Can Spread to a Baby

HBV can pass from an infected pregnant woman to the baby during pregnancy and at delivery. Because this risk is well known and preventable, CDC recommends hepatitis B screening during each pregnancy so that protection for the newborn can be planned right away. 

Protecting the Baby at Birth

If the pregnant woman is known (or suspected) to have HBV, CDC recommends the newborn receive both hepatitis B vaccine and hepatitis B immune globulin (HBIG) as soon as possible after birth—these work best when given within 12 hours. The baby will also need the remaining hepatitis B vaccine doses on schedule to complete the series.

Follow-up After Birth

After the vaccine series is completed, CDC recommends post-vaccination blood testing (HBsAg and anti-HBs) to confirm the baby is protected and not infected. This testing is generally done at 9–12 months of age (and at least 1–2 months after the final vaccine dose).

What Pregnant Women Can Do Now

If you are pregnant, ask your healthcare provider if you were tested for hepatitis B (HBsAg) during this pregnancy. If you have HBV, make sure your delivery team knows, and confirm plans for your baby to receive hepatitis B vaccine and HBIG right after birth, plus follow-up testing later in infancy.

This Page Last Updated: March 25, 2026 at 8:53 PM