Hepatitis B and C during pregnancy

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Abstract

The purpose of this article is to provide a comprehensive overview of current knowledge about pregnancy and hepatitis B virus (HBV) and hepatitis C virus (HCV) infections, and current methods to reduce mother-to-child transmission (MTCT). Maternal infection with HBV or HCV is associated with complicated pregnancy and childbirth outcomes, including MTCT. In countries, including the United States, which introduced postpartum HBV vaccination and immunization with hepatitis B immunoglobulin, MTCT overall decreased to about 5%. However, with maternal HBV levels greater than 200,000 IU/ml, the transmission rate of HBV to neonates is almost 30%. For these patients, there are new recommendations from the European Association for the Study of the Liver (EASL), which indicate that, in addition to vaccination of newborns and their immunization, treatment with antiviral drugs such as tenofovir disoproxil fumarate or telbivudine, used during pregnancy, starting from 32 weeks is necessary, that are safe and effective in preventing mother-to-child transmission. Unlike HBV, no therapy is yet available or recommended to further reduce the risk of mother-to-child transmission of HCV infection, which remains by 3–10%. MTCT of HCV can be minimized by avoiding obstetrics and birth trauma if possible. Young women with HCV should be sent for treatment after delivery, and newborns should be closely monitored to rule out infection. Newer, better tolerated HCV regimens have become more available and should reduce the number of women and babies infected.

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About the authors

Vitaliy A. Kaptilnyy

I.M. Sechenov First Moscow State Medical University

Author for correspondence.
Email: 1mgmu@mail.ru
ORCID iD: 0000-0002-2656-132X

MD, Cand. Sci. (Med.), assistant professor

Russian Federation, Moscow, 119991

Diana Yu. Reyshtat

I.M. Sechenov First Moscow State Medical University

Email: diana.reyshtat@mail.ru
ORCID iD: 0000-0002-5789-3415

V-year student

Russian Federation, Moscow, 119991

Manana V. Berishvili

I.M. Sechenov First Moscow State Medical University

Email: berishvilim@gmail.com
ORCID iD: 0000-0002-0834-0806

MD, Cand. Sci. (Med.), assistant professor

Russian Federation, Moscow, 119991

Mariya N. Zholobova

I.M. Sechenov First Moscow State Medical University

Email: angel1345@mail.ru
ORCID iD: 0000-0003-2842-2910
Russian Federation, Moscow, 119991

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Supplementary files

Supplementary Files
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1. Fig. 1. Phases of chronic hepatitis B virus (HBV) infection. HBV ― hepatitis B virus; HBeAg ― hepatitis B antigen; HBsAg ― hepatitis B surface antigen.

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2. Fig. 2. Screening of pregnant women for hepatitis B virus (HBV). HBsAg(+) ― hepatitis B surface antigen; HBeAg ― e-hepatitis B antigen; HBeAb ― hepatitis B antibody; PMR ― mother-to-child transmission.

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3. Fig. 3. Recommended antiviral treatment of pregnant women with circulating hepatitis B surface antigen ― HBsAg(+). HBV ― hepatitis B virus; HBeAg ― e-hepatitis B antigen; PMR ― mother-to-child transmission; HBIG ― hepatitis B immunoglobulin.

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