Quantitative analysis of HBV DNA level and HBeAg titer in hepatitis B surface antigen positive mothers and their babies: HBeAg passage through the placenta and the rate of decay in babies

Wang, Zhanhui; Zhang, Jin; Yang, Hong; Li, Xiuhui; Wen, Shusheng; Guo, Yabing; Sun, Jian; Hou, Jinlin

doi:10.1002/jmv.10493

Cited by 156 publications

(128 citation statements)

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“…The mean serum HBV DNA level in the mothers of the infants with HBV breakthrough was significantly higher than in the mothers of babies who did not become infected. 35 Thus, he study concluded that HBeAg can cross the human placenta, and disappears from serum within 6 months in most babies. HBV DNA levels in hepatitis B infected mothers are associated with the failure of HBIg and vaccine immunization [see below], and the additional influence of transmitted HBeAg cannot be excluded.…”

Section: Risk Factors For Mother To Infant Transmission Hepatitis B Ementioning

confidence: 98%

Chronic Hepatitis B Virus Infection and Pregnancy

Kumar

Singh

Sinha

2012

Journal of Clinical and Experimental Hepatology

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Planning of pregnancy and management of chronic hepatitis B virus during pregnancy includes recognition of maternal virological status, assessment of liver disease severity and minimization of risk for mother to infant transmission of infection. Decisions regarding the use of antivirals during pregnancy need to be individualized. Monitoring for infection and immunization in newborns is also important. For mothers on antiviral therapy, breastfeeding is not recommended. ( J CLIN EXP HEPATOL 2012;2:366-381) A pproximately 400 million people are chronically infected with hepatitis B virus (HBV) worldwide, 1 and almost half have acquired their infections either through mother to infant transmission or in early childhood, especially in countries where HBV has intermediate to high prevalence.2 In Asia, 8%-10% of the population is chronically infected with HBV, and up to 50% of new cases of hepatitis B infection are due to mother to infant transmission.3 In contrast, the majority of new hepatitis B cases in developed countries are the result of horizontal transmission in adulthood. Before the adoption of standard passive-active immunoprophylaxis treatment, approximately 70%-90% of infants born to hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) positive mothers became chronically infected with HBV. 4 The mother to infant transmission rate was reduced to 5%-10% when infants received appropriate postnatal hepatitis B immunoglobulin (HBIg) and a series of HBV vaccines. However, despite passive-active immunoprophylaxis provided to infants, up to 8%-30% of infants born to highly viremic mothers still become infected with HBV (Figures 1-3). This review will address several issues important to chronic hepatitis B virus infection and pregnancy including effect of pregnancy on chronic HBV infection, effect of chronic HBV infection on pregnancy, mother to infant transmission, safety data on HBV antivirals during pregnancy, management of chronic HBV infection in women who desire pregnancy or become pregnant while taking antivirals. PREVALENCE OF CHRONIC HEPATITIS B VIRUS INFECTION AMONG PREGNANT WOMEN IN INDIAThe prevalence of chronic HBV infection varies widely, with rates ranging from 0.1% to 20% in different parts of the world.2 "High" prevalence (HBsAg positivity rates > 8%) regions include the Asia (except Japan), parts of the Middle East, sub-Saharan Africa, and the Amazon basin. "Intermediate" (2%-7% HBsAg positive) prevalence regions include, the Indian subcontinent, parts of central Asia and the Middle East, Eastern and Southern Europe, as well as parts of South America. "Low" prevalence (<2% HBsAg positive) regions include the United States, Northern Europe, Australia, Japan and the southern part of South America. Overall, 45% of the world population lives in "high" prevalence regions.The HBsAg positivity rate of Hepatitis B in India is different in the different regions of the country. The overall chronic HBsAg positivity rate is often quoted as being 4.7%.5 In India, the prevalence rate of HBsAg...

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Section: Risk Factors For Mother To Infant Transmission Hepatitis B Ementioning

confidence: 98%

Chronic Hepatitis B Virus Infection and Pregnancy

Kumar

Singh

Sinha

2012

Journal of Clinical and Experimental Hepatology

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“…Epidemiologic reviews indicate that Asian patients generally undergo HBeAg seroconversion at a median age of 35 years. Viral clearance occurs at an estimated annual incidence of 2-15% [25,26]. In a cross-sectional analysis of 544 women, aged 18-50 years, with CHB, who were followed in a district hospital in Hong Kong, 38.4% were HBeAg positive and 61.6% were HBeAg negative [27].…”

Section: Prevalence Of Chb Among Asian Women Of Childbearing Agementioning

confidence: 99%

Chronic hepatitis B in Asian women of childbearing age

Leung

2009

Hepatol Int

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Hepatitis B virus (HBV) infection is a serious clinical problem affecting approximately 2 billion people worldwide. An estimated 350 million live with chronic hepatitis B (CHB) infection and are at an increased risk for serious liver sequelae and death from acute or chronic consequences of CHB infection. Individuals with CHB have a 20-30% risk of early death from complications, including liver cirrhosis and hepatocellular carcinoma. In the Asia-Pacific region, half of the CHB burden results from vertical or mother-to-child transmission, with early childhood horizontal transmission accounting for the remaining half. Screening and vaccination are key factors in the successful prevention and control of HBV infection. Over the last 20 years, the implementation of screening programs and universal HBV vaccination for all individuals born in endemic areas have reduced the prevalence of HBV infection and HBV-related liver diseases among individuals younger than 30 years. Women of childbearing age are key stakeholders in preventing HBV infection and, as such, play a critical role in reducing the vertical and horizontal transmission of HBV. Further efforts are needed to implement screening and educational programs for women of childbearing age, particularly those with CHB, to prevent the transmission of HBV to newborns, spouses, other household members, and sexual partners. In addition, healthcare workers need to learn how to avoid iatrogenic transmission in the healthcare setting. This article reviews these issues and highlights areas in which their engagement with public health efforts serves to improve quality of life and society as a whole.

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“…8,9 Both infected and uninfected infants have been shown to encounter HBeAg in utero, but exposure to hepatitis B core antigen (HBcAg), which would indicate possible exposure to virions, has not been documented in babies of either HBeAg 1 or HBeAg 2 mothers. 8,10 Prevention of mother-to-infant transmission has been largely achieved by the administration of passive hepatitis B immunoglobulin and active immunoprophylaxis to all neonates born to carrier mothers. However, the added benefit of passive immunoprophylaxis in newborns of HBsAg 1 /HBeAg 2 carrier mothers has recently been questioned.…”

Section: Introductionmentioning

confidence: 99%