Real-world implementation of a multilevel interventions program to prevent mother-to-child transmission of HBV in China

Abstract Reducing hepatitis B virus (HBV) mother-to-child transmission (MTCT) is a fundamental step toward the HBV elimination goal. The multicentred, multilevel SHIELD program aimed to use an intense intervention package to reduce HBV MTCT in China. This study was conducted in diverse health settings across China, encompassing 30,109 pregnant women from 178 hospitals, part of the interim analysis of stage II of the SHIELD program, and 8,642 pregnant women from 160 community-level health facilities in stage III of the SHIELD program. The study found that the overall MTCT rate was 0.23% (39 of 16,908; 95% confidence interval (CI): 0.16–0.32%) in stage II and 0.23% (12 of 5,290; 95% CI: 0.12–0.40%) in stage III. The MTCT rate was lower among participants who were compliant with the interventions (stage II: 0.16% (95% CI: 0.10–0.26%); stage III: 0.03% (95% CI: 0.00–0.19%)) than among those who were noncompliant (3.16% (95% CI: 1.94–4.85%); 1.91% (95% CI: 0.83–3.73%); P < 0.001). Our findings demonstrate that the comprehensive interventions among HBV-infected pregnant women were feasible and effective in dramatically reducing MTCT.