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2014 ; 3 Suppl 1
(Suppl 1
): S7-S12
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Prevention of Perinatal Hepatitis B Virus Transmission
#MMPMID25232477
Nelson NP
; Jamieson DJ
; Murphy TV
J Pediatric Infect Dis Soc
2014[Sep]; 3 Suppl 1
(Suppl 1
): S7-S12
PMID25232477
show ga
Hepatitis B virus (HBV) infection, the most common form of chronic hepatitis
worldwide, is a major public health problem affecting an estimated 360 million
people globally. Mother-to-child transmission (MTCT) is responsible for more than
one third of chronic HBV infections worldwide. An estimated 15%-40% of persons
chronically infected develop HBV-related complications, such as cirrhosis and
hepatic carcinoma, and 25% die from these complications. MTCT can occur during
pregnancy or during delivery. Screening pregnant women for HBV infection,
providing infant postexposure prophylaxis, and maternal treatment with antiviral
medications are strategies for reducing MTCT transmission rates and the global
burden of new chronic HBV infections. Administration of hepatitis B immune
globulin (HBIG) and hepatitis B (HepB) vaccine within 24 hours of birth, followed
by completion of the vaccine series, is 85%-95% efficacious for prevention of
MTCT. Despite timely post-exposure prophylaxis, MTCT occurs in 5%-15% of infants.
Hepatitis B surface antigen (HBsAg) positive, hepatitis e antigen (HBeAg)
positive mothers with HBV DNA level ?10(6) copies/mL (>200 000 IU/mL) are at
greatest risk of transmitting HBV to their infants. Consensus recommendations and
evidence-based guidelines for management of chronic HBV infection and screening
of pregnant women have been developed. The safety and efficacy of antiviral drug
use during pregnancy are areas of ongoing research. Substantial advances have
been achieved globally in reducing MTCT, but MTCT remains an ongoing health
problem. Attaining a better understanding of the mechanisms of MTCT, implementing
existing policies on maternal screening and infant follow-up, and addressing
research gaps are critical for further reductions in MTCT transmission.