Abstract

Hepatitis B virus (HBV) is a main cause of chronic liver disease worldwide and can lead to severe liver diseases. The World Health Organization has planned to eliminate viral hepatitis, including hepatitis caused by HBV and hepatitis C virus, by 2030. As mother-to-child transmission (MTCT) of HBV is a main cause of chronic HBV infection, MTCT prevention is the main target to reduce the risk of chronic HBV infection and eliminate the disease. Recent clinical trials and meta-analyses found that antiviral therapy could prevent MTCT effectively in mothers with ≥200,000 IU/mL of HBV DNA, in combination with serial vaccination and hepatitis B immune globulin administration in infants. Despite the preventive role of antivirals for MTCT of HBV, there are several concerns regarding antiviral therapy with respect to the safety of the mother and fetus during pregnancy. This review summarizes the benefits and risks of antiviral treatment during pregnancy in women with chronic HBV infection.

Highlights

  • This review summarizes the benefits and risks of antiviral treatment during pregnancy in women with chronic hepatitis B virus (HBV) infection

  • World Health Organization declared the elimination of viral hepatitis by 2030, including hepatitis caused by HBV and hepatitis C virus, as a public health goal

  • Preventing mother-to-child transmission (MTCT) of HBV is the main target to reduce the risk of chronic hepatitis B (CHB) and eliminate the disease

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Summary

Introduction

The global prevalence of hepatitis B virus (HBV) was 3.5% in 2015 [1]. Approximately. The main cause of HBV transmission is mother-to-child transmission (MTCT) during pregnancy and the peripartum period [5]. This is because 90% of the infections in infants become chronic; otherwise only 6% of infections in people over the age of 5 years become chronic [1]. Preventing MTCT of HBV is the main target to reduce the risk of chronic hepatitis B (CHB) and eliminate the disease. Infants from hepatitis B e antigen (HBeAg)-positive mothers or mothers with a high viral load still have a risk of acquiring the infection by MTCT [8,9].

Mechanism of MTCT of HBV
Immunization Strategy to Prevent MTCT of HBV
Antiviral Treatment during Pregnancy for the Prevention of MTCT of HBV
Fetal Risks Associated with Antiviral Exposure during Pregnancy
Postpartum Follow-Up of the Mother and Child
Breastfeeding in Women Who Received Antiviral Treatment
Future Perspectives
Findings
10. Conclusions
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