Chronic hepatitis B virus (HBV) infection due to mother-to-child transmission during the perinatal period remains an important global health problem. Despite standard passive-active immunoprophylaxis with hepatitis B immunoglobulin and hepatitis B vaccine in neonates, up to 8.5% of newborns still acquire HBV infection. Thus, management of chronic HBV during pregnancy and strategies to prevent mother-to-child transmission are important steps in eradicating or reducing the global burden of chronic HBV infection. To date, the management of HBV infection in pregnancy still needs careful attention because of some controversial aspects, including the influence of pregnancy on the course of HBV replication, safety of antiviral prophylaxis with nucleus(t)ide analogs, postpartum flares of hepatitis after delivery, and the safety of breastfeeding. In this review, we highlight these important issues of preventive strategies in the perinatal period.
*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
M.H.N.: guarantor of article; concept development, study design, data interpretation and critical revision of the manuscript. J.L.: study design, data collection, data analysis and interpretation, drafting of the manuscript. M.S.C.: data interpretation and critical review of the manuscript. T.T.T.: data interpretation and critical review of the manuscript.
T.T.T.: grant/research support/advisory/consultant: BMS, Gilead Sciences, AbbVie, Merck, Intercept, Janssen. M.H.N.: grant/research support: Bristol Myer Squibbs, Gilead Sciences, Janssen Pharmaceutical; Advisory board/consultant: Dynavax Laboratories, Gilead Sciences, Intercept Pharmaceutical, Alnylam Pharmaceutical. The remaining authors declare that they have nothing to disclose.
Address correspondence to: Mindie H. Nguyen, MD, MAS, Division of Gastroenterology and Hepatology, Stanford University Medical Center, 780 Welch Road, Suite CJ250M, Palo Alto, CA 94304 (e-mail: email@example.com).