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February 3, 1993

Hepatitis B in a Prenatal Population-Reply

JAMA. 1993;269(5):589-590. doi:10.1001/jama.1993.03500050067022

In Reply.  —We appreciate the interest by Dankner et al in our article. We agree that a full understanding of a community's baseline prevalence of any disease state is important before instituting general screening programs. A few points, however, bear further clarification. While it is true that based on our findings we proposed that empirical neonatal HBV prophylaxis be considered further, the recommendations were restricted to infants born to unregistered women with positive urine drug test results, not all women without prenatal care. Dankner et al do not mention finding any correlation between positive maternal HBsAg status and positive urine drug test results among the women they studied at their center.Dinsmoor and Gibbs1 also showed a lower prevalence of asymptomatic HBV infection among pregnant Hispanic women in San Antonio, Tex, compared with non-Hispanic women, yet concluded that routine HBsAg screening in these women was still warranted because it