Viral hepatitis in pregnancy

Hepatitis A is usually a benign, self-limited infection. A chronic carrier state does not exist, and perinatal transmission does not occur. Hepatitis B may cause chronic infection, and infants delivered to infected mothers are at considerable risk of developing neonatal hepatitis. Passive and active immunization with HBIG and HBV is highly effective in preventing perinatal transmission. Hepatitis D typically occurs as a coinfection or superinfection with hepatitis B. Patients infected with both viruses are at high risk for chronic liver disease. Perinatal transmission of hepatitis D can be prevented by the immunoprophylaxis used for hepatitis B. Non-A, non-B hepatitis occurs in two distinct forms: parenterally transmitted hepatitis C and enterically transmitted hepatitis E. Perinatal transmission of hepatitis C can occur, particularly in women who are concurrently infected with the human immunodeficiency virus. Neonatal immunoprophylaxis is not yet available. Hepatitis E may be associated with high maternal mortality rates in developing nations. However, a chronic carrier state does not exist, and perinatal transmission does not occur. Table 2 summarizes the most important features of each form of viral hepatitis.