Clinical course of hepatitis B virus infection during pregnancy

Nguyen, Geoffrey C.; Garcia, Ruel T.; Nguyen, Natalie; Trinh, Huy N.; Keeffe, Emmet B.; Nguyen, Mindie H.

doi:10.1111/j.1365-2036.2009.03932.x

Cited by 80 publications

(76 citation statements)

References 21 publications

(39 reference statements)

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“…In one of these patients, interferon treatment had been stopped due to pregnancy and two week later, the exacerbation occurred. It has been shown in some previous studies that exacerbation might appear during pregnancy in patients with chronic hepatitis B; even severe liver failure may develop (13,14,15,16). Exacerbations are usually seen in the last trimester, more often in the post-partum period.…”

Section: Discussionmentioning

confidence: 99%

Causes of Acute Exacerbation of Chronic Hepatitis B Infection: A Report of Case Series

C¹,

Tülek²,

Aktepe³

et al. 2015

vhd

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ÖZETObjective: In the course of chronic hepatitis B infection, acute exacerbations characterized by high ALT and HBV DNA levels may occur. Sometimes icterus and hepatic decompensation may develop in severe cases. In this study, we evaluated characteristics of patients who were diagnosed as having acute exacerbation of chronic hepatitis B and the reasons that lead to exacerbation. Materials and Methods:Patients with acute exacerbation of chronic hepatitis B followed up in a training and research hospital clinic between 2010 and 2014, were retrospectively evaluated. Acute exacerbation was diagnosed by detection of 5-fold increase or more than twice of the previous values in ALT levels and elevation of HBV DNA (>10 5 I.U) in patients with chronic hepatitis. Age, gender, known duration of hepatitis B infection, medication, HBeAg positivity and anti-HBc IgM, ALT, AST, albumin, prothrombin time and HBV DNA levels of patients were recorded.

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Section: Discussionmentioning

confidence: 99%

Causes of Acute Exacerbation of Chronic Hepatitis B Infection: A Report of Case Series

C¹,

Tülek²,

Aktepe³

et al. 2015

vhd

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show abstract

“…Buna karşılık östrojenin atimik erkek farelerde HBV ekspresyonunu baskıladığı da gösterilmiştir. Ayrıca seks steroidlerinin düzeyinin artmasının, karaciğerin sentez, metabolizma ve ekskresyon işlevleri üzerinde olumsuz etkileri de olabilir (22). Annede KHB infeksiyonunun sonuçlarına ilişkin bir olgu-kontrol çalışmasında HBsAg-pozitif gebelerde gestasyonel diabetes mellitus, doğum öncesi kanama ve erken doğum tehdidi riskinin arttığı gösterilmiş ve bu durumun bu kişilerdeki kronik inflamatuar durumla ilişkisinin olabileceği ileri sürülmüştür (23).…”

Section: Kronik Hepatit B'li Gebelerin Yönetimiunclassified

“…KHB'nin akut alevlenmeleri ağır seyredebilir ve %20-30 gibi fatalite hızlarıyla karşılaşılabilir (26,27). Gebelerdeki alevlenmeler üçüncü trimestrde ve hatta doğumdan sonraki 6 ay içinde görülür ve immün reaktivasyon sonucunda ortaya çıkması olasıdır (4,7,18,22).…”

Section: Kronik Hepatit B'li Gebelerin Yönetimiunclassified

Management of Chronic Hepatitis B in Pregnancy: A Consensus Report of the Study Group for Viral Hepatitis of the Turkish Society of Clinical Microbiology and Infectious Diseases

Aygen¹,

Keten²,

Akalın³

et al. 2014

Klimik Dergisi

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ÖzetTürk Klinik Mikrobiyoloji ve İnfeksiyon Hastalıkları Derneği Viral Hepatit Çalışma Grubu, bazı üyelerine, gerek ileri dönemde bir karaciğer hastalığı olan anne için, gerekse hepatit B virusu (HBV) bulaşması riski altındaki doğmamış çocuk için, karmaşık bir sorun oluşturan gebelikte kronik hepatit B yönetimi üzerine odaklanan bir uzlaşı raporu hazırlama görevini vermiştir. Raporda konuyla ilgili literatür ve uluslararası kılavuzlar gözden geçirilmiş ve üzerinde uzlaşılan öneriler sunulmuştur. Gebe hastada kronik hepatit B yönetimi için güncel yayınlardan uyarlanan bir algoritm de önerilmiştir. Doğurganlık çağındaki birçok kadın infeksiyonun immün toleran fazında olduğu için genellikle tedavi edilmeleri gerekmez ve gebeliğin erken dö-nemlerinde tedaviye başlama indikasyonu yoktur. Uygulanan postnatal pasif ve aktif immünoprofilaksiye karşın anneden ço-cuğa HBV bulaşması, yüksek derecede viremik (HBV DNA >200 000 İÜ/ml) gebelerde üçüncü trimestrin başında antiviral tedaviye başlanmasıyla önlenebilir. Potensi ve dirence karşı yüksek genetik bariyeri göz önüne alındığında, tenofovir, aktif hepatit B için tedavileri doğumdan sonra da sürdürülecek annelerde uygun bir seçenek olabilir. AbstractStudy Group for Viral Hepatitis of the Turkish Society of Clinical Microbiology and Infectious Diseases set up a task force to develop a consensus report focused on chronic hepatitis B in pregnancy, a complex issue for both the mother with an advanced liver disease and the unborn child who is under the risk of hepatitis B virus (HBV) transmission. Relevant literature and international guidelines were reviewed, and recommendations agreed are presented in the report. An algorithm adapted from actual publications is also proposed for management of chronic hepatitis B in the pregnant patient. Since many women of childbearing age are in the immune tolerant phase of infection, there is generally no need for therapy and no indication to start therapy during the early stages of pregnancy. Initiation of antiviral therapy in the beginning of the third trimester in highly viremic (HBV DNA >200 000 IU/mL) pregnant women can prevent mother-to-child-transmission of HBV despite postnatal passive and active immunoprophylaxis provided. Given its potency and its high genetic barrier to resistance, tenofovir might be an appropriate option for mothers who might need to continue their treatment for active hepatitis B after delivery. Klimik Dergisi 2013; 26(Suppl. 1): 12-9.

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“…In the vast majority of pregnant women, serious flares of HBV do not happen during pregnancy and there are many instances where aminotransferases become normal [81]. Nevertheless, hepatic flares often occur during the third trimester of pregnancy and even 6 months after labor, reaching rates of 45% [82,83]. These flares cannot be prevented with LAM treatment applied during the third trimester and are not correlated with the age of mother, the number of fetuses, HBeAg seroconversion or the presence of precore or basal-core promoter (BCP) mutations.…”

Section: Pregnant Women With Hepatitis Bmentioning

confidence: 99%

“…These flares cannot be prevented with LAM treatment applied during the third trimester and are not correlated with the age of mother, the number of fetuses, HBeAg seroconversion or the presence of precore or basal-core promoter (BCP) mutations. Therefore, HBsAg + mothers should be closely monitored for many months following labor [82,83].…”

Section: Pregnant Women With Hepatitis Bmentioning

confidence: 99%

Treatment of special populations with chronic hepatitis B infection

Rapti¹,

Hadziyannis²

2011

Expert Review of Gastroenterology & Hepatology

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Clinical course of hepatitis B virus infection during pregnancy

Abstract: SUMMARY BackgroundFor women with hepatitis B virus (HBV) infection, little is known about the natural progression of the disease during pregnancy or its impact on pregnancy outcomes.

Cited by 80 publications

References 21 publications

Causes of Acute Exacerbation of Chronic Hepatitis B Infection: A Report of Case Series

Causes of Acute Exacerbation of Chronic Hepatitis B Infection: A Report of Case Series

Management of Chronic Hepatitis B in Pregnancy: A Consensus Report of the Study Group for Viral Hepatitis of the Turkish Society of Clinical Microbiology and Infectious Diseases

Treatment of special populations with chronic hepatitis B infection

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