Abstract
The HBV infection is a major public health problem. It is estimated that worldwide around 2 billion people have markers that show they passed through this infection. In the majority of the cases of HBV infection occurring in adult patients, the natural evolution is towards HBs Ag clearance (which is though not equivalent in all the cases with complete healing as the virus may persist in the hepatocytes in the form of cccDNA). The situation is completely different when the infection is contracted perinatal (intra- or post- partum or more rarely intrauterine) as in these patients, most frequently the infection evolves to chronic forms, either active or inactive or in the form of immune-tolerance. The vertical transmission of HBV infection represents the main problem regarding the management of this infection in pregnancy. In the following review of the literature I synthetized the data regarding the impact of HBV infection on pregnancy as well as the impact of pregnancy on HBV infection. I also searched data regarding the possibility of father-to-offspring transmission and I tried to clarify the mechanisms that make the transmission possible. Finally, I synthetized the existing recommendations in algorithms that are dedicated to ease the activity of the infectious diseases specialist that has to deal with such cases.
Highlights
The Hepatitis B virus (HBV) infection is a major public health problem
It is estimated that globally 2 billion people have serological markers that prove past HBV infection, and around 248 million people are chronically infected [2,3]
In Romania, the prevalence of the infection has been estimated at 4.4%, with a total percent of 27 of the patients presenting serological markers of past HBV infection [4]
Summary
Women that present a more elevated risk for contracting HBV infection are: intravenous drug users, persons that have multiple sexual partners, contacts of HBV infected people, healthcare workers or midwives from institution where people with disabilities are taking care of, recipients of plasma derivate products (including those with innate coagulation problems), patients that need hemodialysis, personnel from healthcare services and public health departments that come in contact with blood, as well as persons from high endemicity of HBV
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