Prevention of perinatal hepatitis B virus transmission

Cheung, Ka Wang; Seto, Mimi Tin Yan; Lao, Terence T.

doi:10.1007/s00404-019-05190-0

Cited by 25 publications

(21 citation statements)

References 61 publications

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“…For hepatitis viruses, incidence of chronic hepatitis B and that of hepatitis C in under 5-year old (cases per 100,000) were investigated because the risk of acquiring chronic hepatitis is greatest in the perinatal period, with up to 90% of infected newborns becoming chronic carriers. 18,32 Four outcomes for HIV were selected: pregnant women with unknown HIV status (%), pregnant women who have not received antiretroviral therapy (ART) for PMTCT (%), no early infant diagnosis defined as testing within 2 months of birth (%), and final transmission rate, including breastfeeding period. 33 For syphilis, maternal syphilis prevalence (%), no syphilis screening (%), no syphilis treatment (%), and congenital syphilis rate (cases per 100,000 live births) were investigated.…”

Section: Discussionmentioning

confidence: 99%

“…Vertical transmisson of hepatitis B virus depends on the maternal hepatitis B e antigen (HBeAg) status, which is approximately 10-30% in HBeAg(À) carriers and considerably increases to 90% in HBeAg( + ). 18 Hepatitis B immunoglobulin administered to infants at birth reduced mother-to-child transmission from 21% to 6% in HBeAg( + ) carriers and 2.6% to 1% in HBeAg(À) carriers. 38 Pregnant hepatitis B carriers can also benefit from receiving antivirals for PMTCT if they recognize their conditions.…”

Section: Discussionmentioning

confidence: 99%

“…38 Pregnant hepatitis B carriers can also benefit from receiving antivirals for PMTCT if they recognize their conditions. 18 Mother-to-child transmission of hepatitis C virus is the leading cause of pediatric hepatitis C and can occur during intrauterine and peripartum period. 39,40 Maternal ribonucleic acid (RNA) viral load > 6 log IU/mL was identified as an important determinant of vertical transmission.…”

Section: Discussionmentioning

confidence: 99%

“…[11][12][13][14][15][16] Vertical transmission, which is known as motherto-child transmission, influences childrens' health and includes human immunodeficiency virus (HIV) infection, hepatitis B, hepatitis C, and syphilis. [17][18][19] Preventing delivery with unknown infections and prevention of mother-to-child transmission (PMTCT) are required to save children and eradicate vertically transmitted infections from the world. To be aware of the necessity of testing and treatment and to be able to receive management during pregnancy are, therefore, important for pregnant women.…”

Section: Introductionmentioning

confidence: 99%

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Gender Equity and Vertically Transmitted Infections: A Country-Level Analysis Across 153 Countries

et al. 2021

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Purpose: Gender inequality is a barrier to education toward women and accessibility to health facilities, which are important for preventing vertical transmission. This study was conducted to analyze the impact of gender equity on vertically transmitted infections (hepatitis viruses, human immunodeficiency virus [HIV], and syphilis) using country-level indicators. Methods: The relationship between the Global Gender Gap Index (GGGI), which is indicator of gender equity, and vertical transmission was analyzed. GGGI scores were collected from 153 countries in 2020. Vertical transmission included 10 outcomes for hepatitis viruses, HIV, and syphilis. Generalized linear model (GLM) was used for analyzing the relationship. Other predictors included skilled birth attendant and country income. Results: The median GGGI score was 0.706 (interquartile range, 0.664–0.736). GLM showed that the GGGI score was significantly associated with the incidence of both chronic hepatitis B and C in under 5 years (both p <0.001). For HIV, GGGI score was significantly associated with the pregnant women with unknown HIV status ( p =0.001), no early infant diagnosis ( p =0.027), and final transmission rate ( p =0.005). There was no significant predictor for pregnant women who have not received antiretroviral therapy for prevention of mother-to-child transmission. All syphilis indicators have improved in high-income countries compared to low-income countries. GGGI score had a significant association only with no syphilis screening ( p <0.001). Conclusions: A lower GGGI score was associated with higher vertical transmission of hepatitis and HIV. The improvement of gender equity might prevent vertical transmission of these viruses. Further intervention studies are warranted to verify the results.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Gender Equity and Vertically Transmitted Infections: A Country-Level Analysis Across 153 Countries

et al. 2021

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“…18 Tenofovir disoproxil fumarate is the drug of choice for antenatal prophylaxis because of its potent effect and the possibility of mutants resistant to lamivudine and telbivudine, due to prior treatment with those drugs. 11,12,19 Breastfeeding is not contra-indicated for women who are taking TDF. A highly promising rate of antenatal acceptance of TDF (96.6%) was observed among women who had undergone antenatal hepatological review.…”

Section: Discussionmentioning

confidence: 99%

Acceptance of antiviral treatment and enhanced service model for pregnant patients carrying hepatitis B

Hui

Cheung

et al. 2020

Hong Kong Med J

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A service model was established for pregnant women with positive screening results for hepatitis B surface antigen (HBsAg) at Queen Mary Hospital in Hong Kong. All women were offered a blood test for hepatitis B virus (HBV) DNA level during the first antenatal visit. Women with HBV DNA levels of ≥200 000 IU/mL received counselling from hepatologists regarding treatment with antenatal tenofovir disoproxil fumarate (TDF) 300 mg daily. Methods: This retrospective review included women attending our antenatal clinic who exhibited positive HBsAg screening results from 15 May 2017 to 31 December 2019. The proportions of women with positive HBsAg, DNA test acceptance, hepatological review, and TDF acceptance during pregnancy were reviewed. Results: In total, 375 (2.9%) of 13 082 pregnant women had positive HBsAg screening results. Blood tests for HBV DNA and hepatological reviews were offered to 273 women who had not undergone hepatological review prior to pregnancy; the acceptance rate was 97.8%. Sixty (22.6%) pregnant

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Comparison of the efficacy and safety of TAF, TDF, and LdT to prevent the transmission of hepatitis B in pregnant women: A retrospective study

Pan,

Zhang,

Zeng

et al. 2024

Immunity Inflam & Disease

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ObjectiveTo compare the efficacy and safety of telbivudine (LdT), tenofovir alafenamide fumarate (TAF), and tenofovir disoproxil fumarate (TDF) for preventing hepatitis B transmission in immune‐tolerant pregnant women with HBV infection.MethodsWe conducted a retrospective cohort study involving women who had hepatitis B virus deoxyribonucleic acid (HBV DNA) ≥ 2 × 105 IU/mL and initiated LdT, TDF, or TAF to prevent mother‐to‐child transmission (MTCT). The primary endpoint was the safety of mothers and infants. The secondary endpoints were maternal HBV DNA reduction at delivery and MTCT rate.ResultsA total of 96 patients were enrolled in the study (LdT group, n = 36; TDF group, n = 35; TAF group, n = 25). All infants received hepatitis B virus immunoprophylaxis. The MTCT rate was 0%([0 of 25] vs. [0 of 35] vs. [0 of 36], p > .05). No severe liver function damage occurred in any of the mothers. Babies delivered in all groups had prenatal ultrasound screening abnormalities, but abnormality rates were not statistically significant between groups.ConclusionThe application of TDF, TAF, or LdT to immune‐tolerant HBV‐infected pregnant women in middle–late pregnancy can successfully interrupt MTCT of the HBV virus. However, for all three groups of pregnant women who delivered babies with abnormal prenatal ultrasound screening, an expanded sample size may be needed for further observation.

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Prevention of perinatal hepatitis B virus transmission

Cited by 25 publications

References 61 publications

Gender Equity and Vertically Transmitted Infections: A Country-Level Analysis Across 153 Countries

Gender Equity and Vertically Transmitted Infections: A Country-Level Analysis Across 153 Countries

Acceptance of antiviral treatment and enhanced service model for pregnant patients carrying hepatitis B

Comparison of the efficacy and safety of TAF, TDF, and LdT to prevent the transmission of hepatitis B in pregnant women: A retrospective study

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