Prevention of Hepatitis B Virus Carrier State in Infants According to Maternal Serum Levels of HBV Dna

Efficacy and safety of lamivudine treatment for chronic hepatitis B in pregnancy

“…The rate of vertical maternal-infant HBV transmission was 90-100% in mothers who were double positive for both HBsAg and HBeAg [19] . It is probable that such a high transmisson rate has been led by the high viral load [10,11] . The data in our study indicated lamivudine was able to neutralize hepatitis activity and reduction in the viral load might result in fewer pregnancy complications and prevent maternal-infant HBV transmission.…”

“…Perinatal transmission of HBV is the most important cause of chronic HBV infection and remains one serious problem despite passive immunization (hepatitis B immune globulin at birth) and active immunization (hepatitis B vaccination according to the standard 3-dose schedule). In different studies high maternal HBV DNA levels were associated with a vaccination breakthrough [10,11] . Recently nucleoside analogues have been used to prevent mother-to-infant transmission of HIV-1 [12] .…”

Perinatal transmission of hepatitis B virus: could hospitals be doing more?

“…However, vaccination alone could not induce immunity against HBV in some infants born to HBsAgpositive, particularly HBeAg-positive mothers, and the risk of developing chronic HBV infection in infants born to HBeAgpositive mothers was more than 10-20%, despite hepatitis B vaccination [16,17].…”

“…HBIG alone has also been demonstrated to be effective in preventing HBV transmission [15], but with the availability of hepatitis B vaccine, HBIG is typically used as an adjunct to vaccination. HBIG prophylaxis in conjunction with HBV vaccination may be of additional benefit to infants born to HBsAg-positive, particularly HBeAg-positive mothers [16][17][18]. A meta-analysis has shown that combined immunoprophylaxis with hepatitis B vaccination and HBIG could significantly reduce hepatitis B occurrence in newborn infants compared with vaccination alone [15].…”

Doctor‐to‐patient transmission of viral hepatitis B: is it a problem, is there a solution?

“…The HBeAg is a nonstructural viral protein and unlikely to be directly associated with the infectivity of inapparently transmitted blood. HBeAg should be considered a marker of high levels of circulating virus, and the level of viraemia has been found to be associated with the risk of perinatal HBV transmission [7].…”