Chronic hepatitis B in Asian women of childbearing age

Abstract

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.

Seroprevalence of hepatitis B surface antigen and hepatitis B e antigen among childbearing-age women in Mianyang, China

“…The HBeAg seroprevalence among HBsAgpositive childbearing-age women was 9.97% in this study, lower than 24.6%, 34.8%, and 38.4% in Henan, Shangdong province, and Hong Kong [20,21,37]. It was higher than the rate of 7.95% found in HBsAgpositive reproductive women in German [38].…”

Immune persistence after hepatitis B vaccination in infancy – Fact or fancy?

“…1 To control HBV infection, universal neonatal immunisation with the hepatitis B vaccine was introduced more than 3 decades ago, and its efficacy has been reported in many studies that have shown not only a reduction in the prevalence of childhood HBV infection, but also the presence of an anamnestic response that could maintain immunoprotection for many years. [2][3][4][5][6][7][8][9][10][11][12][13][14] Indeed, in Taiwan, following introduction of the vaccine, the incidence of hepatocellular carcinoma (HCC) in children was reduced from 0.54 to 0.20 per 100,000 children aged 6-14 years in those born before versus after the vaccination program.…”

Knowledge about hepatitis B vaccination among women of childbearing age: a cross-sectional study from a rural district of Punjab, Pakistan

“…Although the risk of intrauterine infection is relatively low because the fetus is protected from HBV by the placenta, horizontal transmission from fathers, mothers and playmates with HBV is a significant factor in transmission of this deadly disease. Evidence from longterm follow-up studies on the impact of the implementation of universal HBV vaccination programmes has clearly demonstrated that prevention of mother-to-child transmission is the mainstay for the control of HBV infection in the Asia-Pacific region (2,3).…”