Global elimination of mother-to-child transmission of hepatitis B: revisiting the current strategy

Thio, Chloe L.; Guo, Nan; Xie, Chan; Nelson, Kenrad E.; Ehrhardt, Stephan

doi:10.1016/s1473-3099(15)00158-9

Cited by 90 publications

(70 citation statements)

References 32 publications

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“…A meta-analysis of 1693 pregnant women found up to a 70% reduction in VT in those treated with lamivudine 35,39. Recent emergence of lamivudine-resistant HBV strains40 has turned attention toward other agents, including telbivudine and tenofovir.…”

Section: Hbvmentioning

confidence: 99%

Mechanisms and Prevention of Vertical Transmission in Chronic Viral Hepatitis

Mavilia¹,

Wu²

2017

Journal of Clinical and Translational Hepatology

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Vertical transmission (VT) is the primary route of transmission of viral hepatitis in children. The rate of VT ranges from 1–28% with hepatitis B virus (HBV) and 3–15% with hepatitis C virus (HCV). VT for both viruses can occur during the intrauterine or peripartum period. VT of HBV primarily occurs by intrauterine transmission (IUT). Hepatitis B surface antigen is unable to cross the placenta and, therefore, relies on processes like transplacental leakage, placental infection, cellular transmission by peripheral blood mononuclear cells, and germline transmission. HCV can also infect the fetus by IUT. Both viruses also have the potential for transmission during delivery, when there is increase chance of maternal–fetal blood exposure. HBV and HCV share some common risk factors for VT, including maternal viral load, human immunodeficiency virus co-infection and neonatal sex. Prevention of VT differs greatly between HBV and HCV. There are several alternatives for prevention of HBV VT, including antiviral medications during the third trimester of pregnancy and HBV vaccine, as well as hepatitis B immunoglobulin administration to infants post-partum. In contrast, there are no preventative interventions available for HCV. Despite these differences, the key to prevention with both viruses is screening women prior to and during pregnancy.

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Section: Hbvmentioning

confidence: 99%

Mechanisms and Prevention of Vertical Transmission in Chronic Viral Hepatitis

Mavilia¹,

Wu²

2017

Journal of Clinical and Translational Hepatology

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“…This risk is much higher than from horizontal transmission where the rate of chronicity is 30–50% when infected before 6 years of age and <5% when infected in adulthood [1, 5, 6]. Despite improved childhood HBV vaccination worldwide, MTCT still accounts for about 50% of new HBV infections in high endemic countries and one-third in low endemic countries [7, 8, 9, 10]. Therefore, preventing MTCT is crucial for decreasing HBV prevalence.…”

Section: Introductionmentioning

confidence: 99%

Knowledge of and attitudes towards hepatitis B and its transmission from mother to child among pregnant women in Guangdong Province, China

et al. 2017

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BackgroundHepatitis B virus (HBV) infection remains a serious public health problem worldwide. Mother-to-child transmission (MTCT) of HBV is the major mode of transmission in HBV-endemic areas, including China, where little is known about pregnant women’s knowledge of and attitudes towards HBV infection and MTCT.MethodsA cross-sectional survey, conducted in pregnant women in Guangdong Province, China, measured HBV knowledge and attitudes using a questionnaire, at one tertiary and two rural hospitals.ResultsThe total response rate was 94.5% (737/780). Of the 11 knowledge questions, the mean score was 6.73 ± 3.04 (mean ± SD). Most pertinent to preventing MTCT, 53.3% of the respondents did not know that HBV can be transmitted through unprotected sexual intercourse and nearly 20% did not know that HBV can be transmitted from mother to infant. The results of the four attitude questions was better with 83% and 85% being willing to be screened for HBV and let their baby receive HBV vaccine and HBIg, respectively. However, only 16.5% of respondents agreed that they would be willing to take drugs that are known not to harm the fetus to prevent MTCT of HBV. In multivariable analysis, higher education level was associated with better knowledge and attitude scores.ConclusionsKnowledge about HBV among pregnant women was poor and needs to be improved to prevent MTCT of HBV. Health education needs to be directed towards pregnant mothers, particularly less educated mothers, in high HBV endemicity settings.

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“…The main routes of HBV transmission to children are vertical mother-to-child transmission during childbirth and horizontal transmission among family members for children younger than 5 years [6, 7]. The risk of vertical transmission increases with higher maternal HBV DNA levels and with vaginal delivery [8].…”

Section: Introductionmentioning

confidence: 99%

Changes in hepatitis B virus antibody titers over time among children: a single center study from 2012 to 2015 in an urban of South Korea

et al. 2017

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BackgroundHepatitis B virus (HBV) infection is the most common cause of liver disease in endemic areas such as South Korea. After HBV vaccination, hepatitis B surface antibody (HBsAb) titers gradually decrease. Trends in HBsAb titers have not been evaluated among children in South Korea over the past decade.MethodsWe screened 6155 patients (aged 7 months to 17 years) who underwent HBV antigen/antibody testing at Chung-Ang University Hospital from May 2012 to April 2015. Titer criteria were defined as follows: positive, titer ≥100 IU/L; weakly positive, titer 10–99 IU/L; and negative, titer <10 IU/L. We also compared titers before and 1 month after a single booster vaccination.ResultsOf the 5655 patients included, 3016 were male and 5 (0.09%) tested positive for HBV surface antigen. A marked reduction in antibody titer was observed until 4 years of age. Thereafter, the titers showed fluctuating decreases. HBsAb titers reached their lowest levels by 14 years of age. After 7 years of age, 50% of patients tested negative for HBsAb. Simple linear analysis showed that the titer reached levels of <10 IU/L and zero at 12.9 and 13.4 years of age, respectively. 1 month after a single booster vaccination was administered to those who were HBsAb-negative (n = 72), 69 children (96%) had developed antibodies while 3 (4%) remained HBsAb-negative.ConclusionsIn conclusion, the continuous reduction in HBsAb titers over time and in each age group was confirmed. The titer level was shown significant decline until age 4. More than half of the sample had negative titers after age 7 years. After booster vaccination, most of child significantly increase titer level.

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Global elimination of mother-to-child transmission of hepatitis B: revisiting the current strategy

Cited by 90 publications

References 32 publications

Mechanisms and Prevention of Vertical Transmission in Chronic Viral Hepatitis

Mechanisms and Prevention of Vertical Transmission in Chronic Viral Hepatitis

Knowledge of and attitudes towards hepatitis B and its transmission from mother to child among pregnant women in Guangdong Province, China

Changes in hepatitis B virus antibody titers over time among children: a single center study from 2012 to 2015 in an urban of South Korea

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