Indications for antiviral therapy for chronic hepatitis B in pregnant mothers

Abstract

The use of antiviral therapy for chronic hepatitis B virus (HBV) infection in the setting of pregnancy needs to be individualised based on limited data. We report a case of a 34-year-old Korean-American woman with a history of pregnancy with emergent caesarean section due to prolonged labour in the setting of HBV e-antigen (HBeAg) positive chronic HBV with a pretreatment baseline HBV DNA level of 110000 000 million copies per mL. Her first delivery was complicated by mother-to-child transmission (MTCT) of HBV infection to her daughter despite standard active and passive immunoprophylaxis. Our case report highlights an important clinical decision-making step regarding the timing of antiviral therapy in the management of chronic HBV in pregnant women with high risk of MTCT.

Prophylactic effect of tenofovir on viral reactivation in immunocompromised pregnant women living with hepatitis B virus

“…[ 1 ] However, the appropriate prophylaxis for hepatitis flare during gestation for this population has yet to be determined. [ 2 , 3 ]…”

“…[1] However, the appropriate prophylaxis for hepatitis flare during gestation for this population has yet to be determined. [2,3] Antiviral agents that inhibit HBV replication, such as lamivudine, tenofovir disoproxil fumarate (TDF), and telbivudine, which have been administered to pregnant women with a high HBV viral load, may reduce the risk of vertical transmission. [4] The 2020 World Health Organization recommended that pregnant women testing positive for HBsAg with an HBV DNA ≥ 200,000 IU/ ml receive TDF from the 28th week of pregnancy until at least birth, to prevent mother-to-child transmission of HBV.…”