Management of mother-to-child transmission of hepatitis B virus: Propositions and challenges

J Clin Virol. 2016 Apr:77:32-9. doi: 10.1016/j.jcv.2016.02.003. Epub 2016 Feb 6.

Abstract

Chronic hepatitis B virus (HBV) infection due to mother-to-child transmission (MTCT) during perinatal period remains an important global health problem. Despite standard passive-active immunoprophylaxis with hepatitis B immunoglobulin (HBIG) and hepatitis B vaccine in neonates, up to 9% of newborns still acquire HBV infection, especially these from hepatitis B e antigen (HBeAg) positive mothers. Management of HBV infection in pregnancy still need to draw careful attention because of some controversial aspects, including the failure of passive-active immunoprophylaxis in a fraction of newborns, the effect and necessity of periodical hepatitis B immunoglobulin (HBIG) injection to the mothers, the safety of antiviral prophylaxis with nucleoside/nucleotide analogs, the benefit of different delivery ways, and the safety of breastfeeding. In this review, we highlight these unsettled issues of preventive strategies in perinatal period, and we further aim to provide an optimal approach to the management of preventing MTCT of HBV infection.

Keywords: Antiviral therapy; Breastfeeding; Hepatitis B virus; Immunoprophylaxis; Mother to child transmission.

Publication types

  • Review

MeSH terms

  • Antiviral Agents / therapeutic use
  • Breast Feeding / adverse effects
  • Child
  • Disease Management
  • Female
  • Hepatitis B / drug therapy*
  • Hepatitis B / immunology
  • Hepatitis B / transmission*
  • Hepatitis B / virology
  • Hepatitis B virus / physiology*
  • Hepatitis B, Chronic / drug therapy
  • Hepatitis B, Chronic / transmission
  • Hepatitis B, Chronic / virology
  • Humans
  • Immunoglobulins / administration & dosage
  • Immunoglobulins / immunology
  • Infant, Newborn
  • Infectious Disease Transmission, Vertical* / prevention & control
  • Pregnancy

Substances

  • Antiviral Agents
  • Immunoglobulins
  • hepatitis B hyperimmune globulin