The Silent Epidemic in Maternal Health: Why More Pregnant Women Need Hepatitis B Screening
- Hepatitis B remains one of the world’s most underdiagnosed infections.[1]
- Untreated hepatitis B can remain silent for years while increasing the risk of severe liver disease and preventable infant infection.[1,2]
- Integrated point-of-care testing during antenatal care visits presents an important opportunity to identify undiagnosed infections and support measures aimed at reducing transmission to newborns.[2,3]
A pregnant woman attending her first antenatal care (ANC) appointment will often be screened for conditions that could affect her health and the health of her unborn child, including HIV and syphilis, but not always for hepatitis B virus (HBV) infection. This is not because hepatitis B is rare; in fact, quite the opposite. Millions of people worldwide are living with chronic hepatitis B infection, yet many remain unaware of their infection because the disease can progress silently for years without symptoms.[1] As a result, infection is often diagnosed only after serious liver complications develop.[1]
Late diagnosis increases healthcare costs, may limit treatment options and contributes to preventable illness and death.[1] For pregnant women, delayed diagnosis creates an additional risk of vertically transmitting the virus to their babies during childbirth.[2] That missed opportunity is why hepatitis B needs to be seen not only as a liver disease, but as a maternal and child health priority. For healthcare companies such as Abbott, there is an opportunity to help health systems make every ANC touchpoint work harder by bringing reliable, rapid and integrated testing closer to the point of care.
The central question is no longer whether hepatitis B can be detected, prevented or managed. It can. The question is whether health systems are using routine moments of care, especially pregnancy, to find the infection early enough to enable interventions that can improve outcomes for mothers, infants and families.
- Hepatitis B is often silent, but its consequences are not.[1]
- ANC offers a critical window to prevent mother-to-child transmission through timely immunoprophylaxis.[2,3]
- Integrated testing can help expand access while reducing practical barriers for patients and frontline healthcare workers.[3]
- Africa has the tools to change the trajectory; now systems must scale them.[1,3]
The cost of not knowing
Hepatitis B remains one of the world’s most significant infectious diseases despite being preventable and treatable. According to the World Health Organization’s (WHO) Global Hepatitis Report 2026, an estimated 240 million people were living with chronic hepatitis B in 2024, and the WHO African Region accounted for 68% of new hepatitis B virus infections globally.[1]
Behind these numbers are people who may be asymptomatic for years while the virus quietly damages the liver. When hepatitis B is not detected, the first sign of illness may be cirrhosis, liver cancer or liver failure.[1] For families, delayed diagnosis may contribute to repeated clinic visits, rising treatment costs, lost income and the emotional burden of managing a condition that could have been identified much earlier.
“Hepatitis B challenges health systems because it is often invisible until the consequences are severe,” says Dr Evans Mathebula, Senior Medical Affairs Manager at Abbott’s rapid diagnostics business in Africa. “If we wait for symptoms, we have waited too long. The priority should be to make hepatitis B screening routine, accessible and connected to care, particularly at moments when people are already engaging with the health system.”
This is especially important in maternal care. Pregnancy represents one of the most important opportunities to identify previously undiagnosed hepatitis B infection. For many women, ANC is among the few periods of regular engagement with the healthcare system.[2] This visit already serves as an important screening and health education opportunity and can facilitate preventive interventions. Many African countries have made important progress in preventing mother-to-child transmission of HIV. That progress shows what is possible when testing, treatment, policy and community trust are aligned. Hepatitis B now needs the same systems discipline, because the antenatal care clinic may be one of the few reliable points of contact between a pregnant woman and the health system.
This approach aligns with the WHO’s triple elimination initiative, which encourages countries to eliminate mother-to-child transmission of HIV, syphilis and hepatitis B together, rather than through fragmented disease-specific programmes.[3] It recognises a simple reality: healthcare systems across Africa continue to face constraints, workforce pressures and laboratory challenges. In this context, adding new screening priorities must be practical and sustainable. Additionally, pregnant women should not have to navigate three separate pathways when one integrated screening moment can support identification of multiple risks and enable timely care during a single encounter.[3]
An integrated antenatal panel that screens for HIV, syphilis and hepatitis B from a single finger-prick is one example of how health systems can simplify access while maintaining a comprehensive standard of care.[3] For mothers, it can help reduce the risk of missed results and clarify next steps. For healthcare workers, it can support faster decision-making at the point of care when linked to appropriate follow-up pathways. For newborns, timely identification of maternal hepatitis B can support measures that reduce the risk of exposure and enable timely preventive action.
“The most powerful public health interventions are those that fit naturally into the realities of existing care,” adds Mathebula. “The easier it is for healthcare workers to identify hepatitis B during a single antenatal visit, through the use of an integrated panel, the sooner patients can be considered for appropriate follow-up care. We are not only improving diagnosis; we are giving clinicians the information they need to support mothers, help reduce the risk of infant infection and strengthen confidence in the health system.”
A hopeful path to elimination
For too long, hepatitis B has remained overshadowed by other infectious diseases despite its scale and impact. The tools needed to prevent transmission, diagnose infection and support long-term management already exist.[1] What remains is the challenge of finding the millions of people who are living with this virus without knowing it, starting with those accessing maternal and primary healthcare.
To move from awareness to action, policymakers and healthcare leaders should prioritise routine hepatitis B screening in antenatal care, support point-of-care testing in decentralised settings, strengthen linkage to treatment and ensure newborns receive timely protection.[1,3] These are practical steps that can turn a silent infection into a manageable health issue and help prevent transmission to the next generation.
Eliminating hepatitis B as a public health threat will require more than technology alone. It will require political will, domestic investment, continued education to increase awareness, trusted community engagement and health systems designed around people’s real lives. But the path is clear: if one antenatal care visit can identify risk, enable timely care and support measures that help reduce a child’s risk of infection, then it is one of the most powerful opportunities public health has to change two lives at once.
References:
[1] World Health Organization. (2026). Global hepatitis report 2026. Geneva: World Health Organization.
[2] Afolabi, I. B., Phillips, J. C., El-Chaar, D., Bainbridge, S. A., & Phillips, K. P. (2026). Preventing vertical transmission of hepatitis B in sub-Saharan Africa: protocol for a systematic review and meta-analysis on vaccination uptake and determinants among pregnant women. BMJ Open, 16(1), e113229. https://doi.org/10.1136/
[3] World Health Organization & United Nations Children’s Fund. (2025). Country guidance for planning triple elimination of mother-to-child transmission of HIV, syphilis and hepatitis B virus programmes. Geneva: World Health Organization.
