• Potential conflict of interest: Nothing to report.


To the Editor:

We would like to point out an omission in the AASLD Practice Guidelines on Chronic Hepatitis B published in the February 2007 issue of HEPATOLOGY.1 In the section discussing the counseling and prevention of hepatitis B on pages 508-509 and in the accompanying table (Table 3), when discussing infants born to hepatitis B virus (HBV)-infected mothers, the authors neglected to discuss the issue of breast-feeding. This is certainly worth mentioning because some mothers feel breast-feeding to be an integral part of the care they provide to their infants, and mothers prohibited from breast-feeding may feel some sense of inadequacy. As you know, breast-feeding is not prohibited in HBV-infected mothers, as proven by several studies, some of which are listed here.2–4 Furthermore, because infants should routinely receive HBV immune globulin and HBV vaccine, they are almost universally protected against postpartum maternal HBV transmission.

We think an additional 1-2 sentences should be included in the guidelines to address this issue.

Ravi Jhaveri*, Nancy Murray†, * Division of Infectious Diseases, Duke Children's Hospital, Durham, NC, † Duke Children's Primary Care, Duke Children's Hospital, Durham, NC.