Hepatitis B and Pregnancy, the Scientific Basis for Perinatal Prevention

Abstract

Hepatitis B and its complications are one of the major global health problems. Around 2 billion individuals are infected by hepatitis B virus (HBV) worldwide, more than 350 million are chronically infected, and approximately 15 to 40 percents of them will develop serious complications such as liver cirrhosis, hepatic failure, or hepatocellular carcinoma (HCC). The worldwide prevalence of chronic HBV infection ranges from 0.1 to 20 percent and varies widely in different geographic areas. According to the prevalence rate, WHO has classified countries into 3 levels: high areas (>8%) such as Africa, Asia, Western Pacific and Middle East; intermediate areas (2–8%) such as South America and Eastern Europe, and low areas (<2%) such as Western Europe, North America, and Australia.

Efficacy of maternal tenofovir disoproxil fumarate in interrupting mother‐to‐infant transmission of hepatitis B virus

“…Huey-Ling Chen, 1,2,3 Chien-Nan Lee, 4 Chin-Hao Chang, 5 Yen-Hsuan Ni, 1 Ming-Kwang Shyu, 3 Shih-Ming Chen, 7 Jen-Jan Hu, 8 Hans Hsienhong Lin, 9 Lu-Lu Zhao, 10 Shu-Chi Mu, 11 Ming-Wei Lai, 12 Chyi-Long Lee, 13 Hsien-Ming Lin, 14 Ming-Song Tsai, 15 Jenn-Jeih Hsu, 16 Ding-Shinn Chen, 3,6,17 K. Arnold Chan, 5 and Mei-Hwei Chang, 1,3 Taiwan Study Group for the Prevention of Mother-to-Infant Transmission of HBV (PreMIT Study)…”

“…Infection with HBV in pregnancy has become an issue of growing importance. [12][13][14][15][16] Issues regarding the care of the mother, fetus, and child, including the interaction of HBV with the pregnant mother and fetus, the effects of pregnancy on the course of chronic HBV infection, indications for antiviral treatment, postpartum liver function fluctuations, and the prevention of perinatal and intrauterine HBV infection, have attracted substantial attention but are not fully understood. Safety data from the Antiretroviral Pregnancy Registry in pregnant human immunodeficiency virus-positive women who have received lamivudine or tenofovir disoproxil fumarate (TDF) have demonstrated no increased risk for mothers or infants.…”

“…17 Chronic HBVinfected women who have highly active hepatic inflammation or advanced fibrosis/cirrhosis during pregnancy may consider starting antiviral therapy during the first through third trimesters. [12][13][14]16 Earlier studies using lamivudine (pregnancy category C) in pregnant women have shown reduced HBV infection rates in children of highly viremic mothers. 18,19 After new and better antiviral drugs in pregnancy category B emerged, there has been enthusiasm over using short-term antiviral agents in pregnant women for prevention of mother-to-infant transmission despite immunoprophylaxis, based on the rationale that transmission mainly occurred during the peripartum period through maternal-fetal transfusion or direct contact of newborns with infected maternal secretions and blood during labor.…”

Seroprevalence of Hepatitis B Surface Antigen Among Pregnant Women Attending Antenatal Clinic in Govt . General Hospital, Anantapuramu (A. P.)

“…(2) Transmission during delivery by contact with maternal infected fluids in the birth canal. (3) Post -natal transmission from mothers to infants during child care or through breast feeding (Chen and Chang -2010). (10) Vertical transmission has been reported in 90% of infants born to HBs Ag positive and HBe Ag positive mothers.…”

“…(3) Post -natal transmission from mothers to infants during child care or through breast feeding (Chen and Chang -2010). (10) Vertical transmission has been reported in 90% of infants born to HBs Ag positive and HBe Ag positive mothers. (Pennap et al 2011).…”