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Management of Chronic Hepatitis B in Pregnancy

Jie Li1, Matthew S Chang, Tram T Tran

  • 1*Division of Gastroenterology and Hepatology, Stanford University Medical Center, Palo Alto ‡Department of Liver Transplant, Cedars Sinai Medical Center, Los Angeles, CA †Department of Infectious Disease, Shandong Provincial Hospital Affiliated to Shandong University, Ji'nan, Shandong, China.

Journal of Clinical Gastroenterology
|August 18, 2017
PubMed

Insights

Preventing mother-to-child transmission of hepatitis B virus (HBV) is crucial. This review examines management strategies for chronic HBV in pregnancy and perinatal prevention, despite current immunoprophylaxis limitations.

Area of Science:

  • Hepatology
  • Virology
  • Immunology

Background:

  • Mother-to-child transmission of chronic hepatitis B virus (HBV) infection during the perinatal period is a significant global health concern.
  • Standard immunoprophylaxis (hepatitis B immunoglobulin and vaccine) in neonates is insufficient, with up to 8.5% of newborns still acquiring HBV infection.
  • Effective management of chronic HBV in pregnant individuals and robust prevention strategies are vital for reducing the global burden of chronic HBV.

Purpose of the Study:

  • To review current challenges and controversies in managing chronic hepatitis B virus (HBV) infection during pregnancy.
  • To highlight key issues in perinatal preventive strategies for HBV transmission.
  • To address the influence of pregnancy on HBV replication, safety of antiviral prophylaxis, postpartum flares, and breastfeeding.

Main Methods:

  • This review synthesizes existing literature on HBV management in pregnancy and perinatal transmission prevention.
  • It focuses on controversial aspects and recent advancements in the field.
  • Key areas examined include the impact of pregnancy on HBV, antiviral safety, and postpartum complications.

Main Results:

  • Pregnancy's influence on HBV replication requires careful consideration.
  • The safety of nucleos(t)ide analog prophylaxis during pregnancy needs thorough evaluation.
  • Postpartum hepatitis flares and the safety of breastfeeding remain areas of concern.

Conclusions:

  • Management of chronic HBV in pregnancy necessitates careful attention to controversial aspects.
  • Enhanced strategies are needed to improve the efficacy of perinatal HBV transmission prevention.
  • Further research is essential to optimize care and reduce the global burden of chronic HBV infection.

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