NOTE: A surveillance case definition is a set of uniform criteria used to define a disease for public health surveillance. Surveillance case definitions enable public health officials to classify and count cases consistently across reporting jurisdictions. Surveillance case definitions are not intended to be used by healthcare providers for making a clinical diagnosis or determining how to meet an individual patient’s health needs.

Clinical Description

Perinatal hepatitis B in the newborn may range from asymptomatic to fulminant hepatitis.

Laboratory Criteria For Diagnosis

Hepatitis B surface antigen (HBsAg) positive

Case Classification


HBsAg positivity in any infant aged >1-24 months who was born in the United States or in U.S. territories to an HBsAg-positive mother


Infants born to HBsAg-positive mothers should receive hepatitis B immune globulin (HBIG) and the first dose of hepatitis B vaccine within 12 hours of birth, followed by the second and third doses of vaccine at 1 and 6 months of age, respectively. Post-vaccination testing for HBsAg and anti-HBs (antibody to HBsAg) is recommended from 3 to 6 months following completion of the vaccine series. If HBIG and the initial dose of vaccine are delayed for >1 month after birth, testing for HBsAg may determine if the infant is already infected.

The 1995 case definition appearing on this page was re-published incorrectly in the 1997 MMWR Recommendations and Reports titled Case Definitions for Infectious Conditions Under Public Health Surveillance.1 Thus, the 1995 and the 1997 versions of this case definition are not identical, and the 1995 version is the correct one.


  1. CDC. (1997). Case Definitions for Infectious Conditions Under Public Health Surveillance. MMWR, 46(RR-10), 1-55.
  2. Ko SC, Fan L, Smith EA, Fenlon N, Koneru AK, Murphy TV. Estimated Annual Perinatal Hepatitis B Virus Infections in the United States, 2000–2009. Journal of the Pediatric Infectious Diseases Society. 2014 Dec 18:piu115.
  3. Terrault NA, Bzowej NH, Chang K-M, et al. AASLD Guidelines for Treatment of Chronic Hepatitis B.
  4. Mast EE, Margolis HS, Fiore AE, Brink EW, Goldstein ST, Wang SA, Moyer LA, Bell BP, Alter MJ; Advisory Committee on Immunization Practices (ACIP). A comprehensive immunization strategy to eliminate transmission of hepatitis B virus infection in the United States: recommendations of the Advisory Committee on Immunization Practices (ACIP) part 1: immunization of infants, children, and adolescents. MMWR Recomm Rep. 2005 Dec 23;54(RR-16):1-31.

Related Case Definition(s)

Page last reviewed: April 16, 2021