Review
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World J Gastroenterol. Sep 7, 2012; 18(33): 4517-4521
Published online Sep 7, 2012. doi: 10.3748/wjg.v18.i33.4517
Management of chronic hepatitis B in pregnancy
Guo-Rong Han, Chuan-Lu Xu, Wei Zhao, Yong-Feng Yang
Guo-Rong Han, Chuan-Lu Xu, Department of Gynecology and Obstetrics, The Second Affiliated Hospital of the Southeast University, Nanjing 210003, Jiangsu Province, China
Wei Zhao, Yong-Feng Yang, Department of Infectious Diseases, The Second Affiliated Hospital of the Southeast University, Nanjing 210003, Jiangsu Province, China
Author contributions: Han GR designed the study and wrote the manuscript with input from the others; Xu CL provided writing assistance; Han GR, Xu CL, Zhao W and Yang YF participated in data collection; Han GR and Xu CL performed the data analysis; and Han GR interpreted the data, wrote the draft and critically revised the manuscript.
Supported by Research Grant for Projects in Infectious Diseases from the Department of Health, Jiangsu Province, China, No. H200804
Correspondence to: Guo-Rong Han, MD, Director of the Department of Gynecology and Obstetrics, The Second Affiliated Hospital of the Southeast University, No.1 Zhongfu Road, Nanjing 210003, Jiangsu Province, China. hanguorong2011@sina.com
Telephone: +86-25-83626372 Fax: +86-25-83626060
Received: December 29, 2011
Revised: March 15, 2012
Accepted: March 29, 2012
Published online: September 7, 2012
Abstract

Pregnancy associated with chronic hepatitis B (CHB) is a common and important problem with unique challenges. Pregnant women infected with CHB are different from the general population, and their special problems need to be considered: such as the effect of hepatitis B virus (HBV) infection on the mother and fetus, the effect of pregnancy on replication of the HBV, whether mothers should take HBV antiviral therapy during pregnancy, the effect of these treatments on the mother and fetus, how to carry out immunization of neonates, whether it can induce hepatitis activity after delivery and other serious issues. At present, there are about 350 million individuals with HBV infection worldwide, of which 50% were infected during the perinatal or neonatal period, especially in HBV-endemic countries. Currently, the rate of HBV infection in the child-bearing age group is still at a high level, and the infection rate is as high as 8.16%. Effective prevention of mother-to-child transmission is an important means of reducing the global burden of chronic HBV infection. Even after adopting the combined immunization measures, there are still 5%-10% of babies born with HBV infection in hepatitis B e antigen positive pregnant women. As HBV perinatal transmission is the main cause of chronic HBV infection, we must consider how to prevent this transmission to reduce the burden of HBV infection. In this population of chronic HBV infected women of childbearing age, specific detection, intervention and follow-up measures are particularly worthy of attention and discussion.

Keywords: Chronic hepatitis B; Hepatitis B virus; Mother-to-child transmission; Perinatal transmission; Pregnancy; Vertical transmission; Antiviral therapy