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Article

Management of hepatitis B in pregnancy: Weighing the options

William D. Carey, MD and Tram T. Tran, MD
Cleveland Clinic Journal of Medicine May 2009, 76 (5 suppl 3) S25-S29; DOI: https://doi.org/10.3949/ccjm.76.s3.06
William D. Carey
Cleveland Clinic
Roles: Supplement Editor
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Tram T. Tran
Associate Professor of Medicine, Geffen UCLA School of Medicine, Medical Director, Liver Transplantation, Center for Liver Disease and Transplantation, Cedars-Sinai Medical Center, Los Angeles, CA
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ABSTRACT

Maternal screening and active and passive immunoprophylaxis have reduced the perinatal, or vertical, transmission of hepatitis B virus (HBV) dramatically. Without immunoprophylaxis, chronic HBV infection occurs in up to 90% of children by age 6 months if the mother is positive for both hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg). Even with immunoprophylaxis, perinatal transmission is possible when the mother is highly viremic and HBeAg positive. Antiviral therapy during the third trimester of pregnancy in high-risk women with chronic HBV infection reduces viral load in the mother and may decrease the risk of perinatal transmission, although data are lacking. Safety data in pregnancy are most robust with lamivudine and tenofovir compared with other therapies. Careful discussion with the patient regarding the risks and benefits of therapy is warranted. Prophylaxis remains the best method of prevention of perinatal transmission.

  • Copyright © 2009 The Cleveland Clinic Foundation. All Rights Reserved.
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Cleveland Clinic Journal of Medicine: 76 (5 suppl 3)
Cleveland Clinic Journal of Medicine
Vol. 76, Issue 5 suppl 3
1 May 2009
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Management of hepatitis B in pregnancy: Weighing the options
William D. Carey, Tram T. Tran
Cleveland Clinic Journal of Medicine May 2009, 76 (5 suppl 3) S25-S29; DOI: 10.3949/ccjm.76.s3.06

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Management of hepatitis B in pregnancy: Weighing the options
William D. Carey, Tram T. Tran
Cleveland Clinic Journal of Medicine May 2009, 76 (5 suppl 3) S25-S29; DOI: 10.3949/ccjm.76.s3.06
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