Management of chronic hepatitis B in pregnancy

Han, Guorong; Xu, Chuanlu; Zhao, Wei; Yang, Yue

doi:10.3748/wjg.v18.i33.4517

Cited by 40 publications

(62 citation statements)

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“…The results of research in this area are somewhat controversial, however, most authors concluded that pregnancy does not affect the course of CHB [3,5,8,9].…”

Section: Problem Statement and Analysis Of The Recent Researchmentioning

confidence: 99%

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HBV-Infection and Pregnancy

Matejko

Matvisiv

2017

Galician med. j.

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To date, the problem of HBV-infection in pregnant women remains relevant and one of the most important for medical science and health care, as it can be considered as a maternal-fetal infection. The aim of the research is to investigate the course of HBV-infection in pregnant women, depending on the duration of the disease, the degree of viremia and the activity of hepatitis, taking into account gestational periods. Materials and methods. The course of pregnancy in 142 women aged 18-35 years with HBV-infection was monitored. Serum markers and viral load (VL) of hepatitis B (HB) were determined, as well as the levels of ALT, AST, thymol test, serum bilirubin levels during each trimester of pregnancy. Results. In pregnant women with HBV-infection, HBsAg-carriage was most often diagnosed, and the replication stages were less frequent (96 and 46, respectively). Clinical picture of the immune-active phase of chronic HBV-infection was oligosymptomatic without violation of pigment metabolism and manifestations of mesenchymal-inflammatory reaction. The minimal degree of cytolysis prevailed, which did not depend on the degree of the viremia. In women with immune-tolerant phase of cytolysis during pregnancy was not observed. In pregnant women with replication stage of HBV-infection and low degree of viremia, the VL increased at 1-2 log compared to the second and third trimesters, and in women with high viremia -at 2-3 log. In most women-carriers of HBsAg moderate degree of viremia predominated, and in the rest -it was not determined. During the entire pregnancy, the immune-tolerant phase of chronic HBV-infection was latent and did not transform into the immune-active phase. Conclusion. Thus, the diagnosis of chronic HBV-infection was verified before pregnancy in 2.8 %, and during pregnancy -in 97.2 % of women. Carriage of HBsAg prevailed in them (67.6 %), and replicative forms were registered in 32.4 % of patients. The peculiarity of replicative forms is subclinical (65.3 %) and asymptomatic (34.7 %) clinical course with low VL (? 105 copies/mL), which in most cases (91.3 %) increases before delivery at 1-2 log and is accompanied by low activity of hepatitis, without violation of pigment metabolism. Keywords HBV-infection; pregnant womenIvano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine *Corresponding author: maranammv@gmail.com Problem statement and analysis of the recent researchIn recent years, viral hepatitis (VH) has become not only a great medical problem but also socio-economic one. According to various estimates, about 2 billion people in the world are infected with hepatitis B virus (HBV) and 300-450 million patients with chronic HBV (CHB), who are a constant source of infection [7,8,9].In Ukraine, among the adult population, the average incidence of HBsAg carriers is 2.2 %, and the incidence of HBV infection in pregnant women exceeds 18 % [1, 2].An important peculiarity of the age structure of patients with CHB in adults is its prevalence in young people of reproductive age (19-29 and ...

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“…The results of research in this area are somewhat controversial, however, most authors concluded that pregnancy does not affect the course of CHB [3,5,8,9].…”

Section: Problem Statement and Analysis Of The Recent Researchmentioning

confidence: 99%

“…According to various estimates, about 2 billion people in the world are infected with hepatitis B virus (HBV) and 300-450 million patients with chronic HBV (CHB), who are a constant source of infection [7,8,9].…”

Section: Problem Statement and Analysis Of The Recent Researchmentioning

confidence: 99%

HBV-Infection and Pregnancy

Matejko

Matvisiv

2017

Galician med. j.

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“…52,93 Some reports support administration of HBIG to pregnant women infected with HBV in order to prevent HBV infection in the uterus. [94][95][96] In the UK, HBIG is accepted for mothers positive for hepatitis B e antigen (HBeAg) or with HBV-DNA levels above 1.0£10…”

Section: Efficacy and Safety Of Hepatitis B Immune Globulin (Hbig)mentioning

confidence: 99%

“…45 Among pregnant women, hepatitis B is a pre-existing or concurrent liver disease, 46 and the clinical symptoms in infected pregnant women are similar to those of non-pregnant women. 47,48 HBV infection does not directly threaten maternal or fetal lives; [49][50][51][52][53][54][55] however, gestational diabetes mellitus, antepartum hemorrhage, and preterm labor have been reported in chronic carriers. [56][57][58] The most significant risk of HBV infection during pregnancy is the potential for viral transmission to the fetus or neonate, 7,[59][60][61][62] which is associated with 4.5 million cases annually.…”

Section: 21mentioning

confidence: 99%

Viral hepatitis vaccination during pregnancy

Zhao

Jin

Zhang

et al. 2016

Human Vaccines & Immunotherapeutics

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Viral hepatitis is a serious global public health problem. It is also a common cause of jaundice and gestational complications in pregnant women. Moreover, infected mothers can transmit the virus to their fetus or neonate, which may increase disease burden and decrease quality of life. To date, commercial vaccines have been developed for hepatitis A, B, and E and are available to the general population. The Advisory Committee on Immunization Practices currently accepts emergency vaccination against hepatitis A and B during pregnancy due to benefits that overweight the potential risks. While there are limited data from trials with limited numbers of samples that suggest the efficacy or safety of hepatitis B and E vaccines in pregnant women, additional data are necessary to provide evidence of vaccination during pregnancy.

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“…According to previous studies in HBV-endemic areas, infection occurs mainly in infancy and early childhood, with mother-tochild transmission (MTCT), also called vertical transmission, accounting for more than 90% of chronic infection in newborns and up to 50% in children less than 3 years old [2]. In China, the rate of HBV infection among women of childbearing age is still high (7.18%) [3] and MTCT may occur prenatally, during delivery, or in the early postpartum period.…”

Section: Introductionmentioning

confidence: 99%