Screening for hepatitis B, HIV and syphilis

A screening blood test for the infectious diseases HIV, syphilis and hepatitis B is offered if you are pregnant in England. If you test positive, treatment can protect your baby.

During your pregnancy, you'll be offered a blood test for 3 infectious diseases: hepatitis B, HIV and syphilis. This is part of routine antenatal screening, which is recommended for every pregnancy.

You will usually be offered the blood test at your booking appointment with a midwife.

The blood test needs to be done as early as possible in pregnancy, ideally by 10 weeks. This is so treatment can be started early, if you need it, to reduce the risk of passing the infection on to your baby.

If you already know you have HIV or hepatitis B, you'll need early specialist appointments to plan your care in pregnancy.

If your partner has HIV, hepatitis B or syphilis, tell your midwife as soon as possible.

Hepatitis B, HIV and syphilis can all be passed to your baby during pregnancy and birth.

Hepatitis B affects the liver and can cause immediate (acute) and long-term (chronic) illness. It's passed on in blood and other body fluids, for example through sexual contact or sharing infected needles.

If you have hepatitis B, you'll be offered specialist care.

If your baby completes a course of vaccinations in their first year, this greatly reduces their risk of developing hepatitis B.

HIV weakens the immune system, making it difficult to fight off infections.

If left untreated, it can lead to AIDS (acquired immune deficiency syndrome).

HIV is passed on in blood and other body fluids through sexual contact or infected needles.

HIV can be passed on to your baby during pregnancy, birth or breastfeeding if it's not treated.

Syphilis is usually passed on through close contact with a syphilis sore during sex. It can also be passed on to a baby during pregnancy.

If untreated, syphilis can cause serious health problems for your baby, or cause miscarriage or stillbirth.

Syphilis is treated with antibiotics. The earlier it's treated, the lower the risk of passing it on to the baby is.

A blood sample is taken from your arm. There are no risks associated with this test, either for you or your baby.

It's your choice to be tested for any or all of these infections.

The tests are recommended to:

  • protect your health through early treatment and care
  • reduce any risk of passing an infection on to your baby, partner or other family members

If you test positive for hepatitis B, HIV or syphilis, your partner and other family members may be offered a test for the infection.

If you decide not to have the test in early pregnancy, you'll be seen by a specialist midwife and offered screening again before you are 20 weeks pregnant. The midwife will discuss the benefits of screening for these infections.

You can ask to have a test for hepatitis B, HIV or syphilis at any time if you change your sexual partner or think you're at risk.

Your midwife will usually discuss your results with you either before or at your next antenatal visit and record them in your notes.

A specialist midwife will contact you if you have tested positive for hepatitis B, HIV or syphilis. This is to arrange appointments to discuss your results and organise a referral for specialist care services.

The specialist care team will offer you further tests and examinations to fully assess your condition, and the treatment and care you'll need.

Hepatitis B

If you have hepatitis B, you'll receive specialist care throughout your pregnancy and after the baby is born. 

Your partner and any other children you have should also be offered a test for infection, and vaccinations if needed.

To prevent the baby getting hepatitis B, they will need vaccinations at the following times:

  • within 24 hours of birth (with an injection of antibodies if required)
  • 4 weeks
  • 8 weeks
  • 12 weeks
  • 16 weeks
  • 1 year, with a blood test to check if infection has been avoided

It's very important that the baby has all 6 doses of the vaccine. The doses at 8, 12 and 16 weeks will be given as part of their routine infant immunisations.

HIV

The risk of passing HIV to the baby can be greatly reduced by:

  • specialist care and treatment
  • medicine
  • planned care for the birth
  • not breastfeeding

Your partner and any other children you have should also be offered a test.

Syphilis

If you have syphilis, you will need urgent referral to a specialist care team. Treatment is usually a course of antibiotics.

Your care team will also offer to test your partner to see if they need treatment as well so that you do not get reinfected.

Your baby may need to be examined and given antibiotics after birth.

You can still get these infections during pregnancy, even after a negative test result. Talk to your midwife or GP if you're worried about anything.

You can catch sexually transmitted infections during pregnancy if you have unprotected sex.

You can also get HIV and hepatitis B if you inject illegal drugs and share needles.

Remember, you can ask to be tested for hepatitis B, HIV or syphilis at any time during pregnancy.

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