Preventing mother-to-child transmission of HBV

Abstract

Hepatitis B virus (HBV) infection is a global public health threat with about 296 million chronic infections worldwide and 1·5 million new infections each year. 1 WHOGlobal progress report on HIV, viral hepatitis and sexually transmitted infections, 2021. Accountability for the global health sector strategies 2016–2021: actions for impact. World Health Organization, Geneva2021 Google Scholar In 2016, WHO developed a global strategy to eliminate hepatitis as a public health threat by 2030, with a goal to reduce incidence by 90% and mortality by 65%. 2 WHOGlobal health sector strategy on viral hepatitis 2016–2021. https://www.who.int/hepatitis/strategy2016-2021/ghss-hep/en/Date: 2016 Date accessed: March 13, 2022 Google Scholar Mother-to-child transmission (MTCT) remains a key contributor to HBV incidence globally, 3 Bierhoff M Nelson KE Guo N Jia Y Thio CL Prevention of mother-to-child transmission of hepatitis B virus: protocol for a one-arm, open-label intervention study to estimate the optimal timing of tenofovir in pregnancy. BMJ Open. 2020; 10e038123 Crossref PubMed Scopus (7) Google Scholar and extra interventions beyond the hepatitis B vaccination for children to decrease MTCT are needed. On that basis, the birth dose of hepatitis B vaccine (HepB-BD) combined with hepatitis B immunoglobulin (HBIg) or tenofovir disoproxil fumarate, or both during pregnancy have been proved to effectively prevent MTCT. 4 Funk AL Lu Y Yoshida K et al. Efficacy and safety of antiviral prophylaxis during pregnancy to prevent mother-to-child transmission of hepatitis B virus: a systematic review and meta-analysis. Lancet Infect Dis. 2021; 21: 70-84 Summary Full Text Full Text PDF PubMed Scopus (63) Google Scholar However, access to HBIg is an issue in many low-income and middle-income countries (LMICs). Immunoglobulin-free strategy to prevent HBV mother-to-child transmission in Cambodia (TA-PROHM): a single-arm, multicentre, phase 4 trialAn immunoglobulin-free strategy using an HBeAg rapid diagnosis test and alanine aminotransferase-based algorithm to assess eligibility for tenofovir, is effective at preventing MTCT of HBV when tenofovir was initiated at least 4 weeks before birth. Full-Text PDF