Management of chronic hepatitis B in pregnancy

World J Gastroenterol. 2012 Sep 7;18(33):4517-21. doi: 10.3748/wjg.v18.i33.4517.

Abstract

Pregnancy associated with chronic hepatitis B (CHB) is a common and important problem with unique challenges. Pregnant women infected with CHB are different from the general population, and their special problems need to be considered: such as the effect of hepatitis B virus (HBV) infection on the mother and fetus, the effect of pregnancy on replication of the HBV, whether mothers should take HBV antiviral therapy during pregnancy, the effect of these treatments on the mother and fetus, how to carry out immunization of neonates, whether it can induce hepatitis activity after delivery and other serious issues. At present, there are about 350 million individuals with HBV infection worldwide, of which 50% were infected during the perinatal or neonatal period, especially in HBV-endemic countries. Currently, the rate of HBV infection in the child-bearing age group is still at a high level, and the infection rate is as high as 8.16%. Effective prevention of mother-to-child transmission is an important means of reducing the global burden of chronic HBV infection. Even after adopting the combined immunization measures, there are still 5%-10% of babies born with HBV infection in hepatitis B e antigen positive pregnant women. As HBV perinatal transmission is the main cause of chronic HBV infection, we must consider how to prevent this transmission to reduce the burden of HBV infection. In this population of chronic HBV infected women of childbearing age, specific detection, intervention and follow-up measures are particularly worthy of attention and discussion.

Keywords: Antiviral therapy; Chronic hepatitis B; Hepatitis B virus; Mother-to-child transmission; Perinatal transmission; Pregnancy; Vertical transmission.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Antiviral Agents / pharmacology
  • Antiviral Agents / therapeutic use
  • Disease Management*
  • Female
  • Hepatitis B virus / immunology
  • Hepatitis B virus / physiology
  • Hepatitis B, Chronic / drug therapy*
  • Hepatitis B, Chronic / immunology
  • Hepatitis B, Chronic / prevention & control
  • Humans
  • Infectious Disease Transmission, Vertical / prevention & control
  • Pregnancy
  • Pregnancy Complications, Infectious / drug therapy*
  • Pregnancy Complications, Infectious / prevention & control
  • Pregnancy Complications, Infectious / virology*
  • Viral Vaccines / immunology
  • Viral Vaccines / therapeutic use
  • Virus Replication / drug effects

Substances

  • Antiviral Agents
  • Viral Vaccines