Management and Elimination of mother-to-child transmission of hepatitis B virus: A therapeutical Approach

Authors

  • Vankodoth Sireesha Assistant Professor, Pharm D Department, CMR College of Pharmacy, Medchal, Hyderabad, India
  • Ch Abhiram Pharm D Student, CMR College of Pharmacy, Medchal, Hyderabad, India
  • Y sneha Pharm D Student, CMR College of Pharmacy, Medchal, Hyderabad, India
  • Syed Mohiuddin Pharm D Student, CMR College of Pharmacy, Medchal, Hyderabad, India
  • Tadikonda Rama Rao Principal, Professor, CMR College of Pharmacy, Kandlakoya, Medchal.

Abstract

A major worldwide health issue is the persistent transmission of the chronic form of the hepatitis B virus (HBV) from mothers to their unborn children (MTCT) during the perinatal period. In endemic areas, HBV infection occurs mainly during infancy and early childhood, with MTCT accounting for approximately half of the transmission routes of chronic HBV infections. Prevention of MTCT is an important step in reducing the global burden of chronic HBV. In addition to such considerations regarding the transmission of HBV to the child, the combination of HBV infection and pregnancy raises several unique management issues. Up to 9% of newborns still acquire HBV infection, especially from mothers who have the hepatitis B e antigen (HBeAg), despite routine passive-active immunoprophylaxis with hepatitis B immunoglobulin (HBIG) and the hepatitis B vaccine. The failure of passive-active immunoprophylaxis in newborns, the impact and requirement of routine hepatitis B immunoglobulin (HBIG) injections to mothers, the safety of antiviral prophylaxis, and the safety of nursing are some of the complications associated with managing HBV infection throughout pregnancy. Chronic HBV infection during pregnancy is usually but may flare after delivery. These unresolved issues are highlighted in this review and we aim to an optimal approach to the management of preventing MTCT of HBV infection.

Keywords: Hepatitis B, perinatal period transmission, immunoprophylaxis, breastfeeding, viremia.

Keywords:

Hepatitis B, perinatal period transmission, immunoprophylaxis breastfeeding, viremia

DOI

https://doi.org/10.22270/jddt.v13i12.6334

Author Biographies

Vankodoth Sireesha, Assistant Professor, Pharm D Department, CMR College of Pharmacy, Medchal, Hyderabad, India

Assistant Professor, Pharm D Department, CMR College of Pharmacy, Medchal, Hyderabad, India

Ch Abhiram, Pharm D Student, CMR College of Pharmacy, Medchal, Hyderabad, India

Pharm D Student, CMR College of Pharmacy, Medchal, Hyderabad, India

Y sneha, Pharm D Student, CMR College of Pharmacy, Medchal, Hyderabad, India

Pharm D Student, CMR College of Pharmacy, Medchal, Hyderabad, India

Syed Mohiuddin, Pharm D Student, CMR College of Pharmacy, Medchal, Hyderabad, India

Pharm D Student, CMR College of Pharmacy, Medchal, Hyderabad, India

Tadikonda Rama Rao, Principal, Professor, CMR College of Pharmacy, Kandlakoya, Medchal.

Principal, Professor, CMR College of Pharmacy, Medchal, Hyderabad, India

References

1 Goyal A, Murray JM, The impact of vaccination and antiviral therapy on hepatitis B and hepatitis D epidemiology, PLoS One 9 (2014) e110143. https://doi.org/10.1371/journal.pone.0110143 PMid:25313681 PMCid:PMC4196970
2 Yi P, Chen R, Huang Y, Zhou RR, Fan XG. Management of mother-to-child transmission of hepatitis B virus: Propositions and challenges. Journal of Clinical Virology, 2016 Apr; 77:32-9. https://doi.org/10.1016/j.jcv.2016.02.003 PMid:26895227
3 Janahi EM. Prevalence and Risk Factors of Hepatitis B Virus Infection in Bahrain, 2000 through 2010. Ray R, editor. PLoS ONE. 2014 Feb 3; 9 (2):e87599. https://doi.org/10.1371/journal.pone.0087599 PMid:24498341 PMCid:PMC3911996
4 https://apps.who.int/iris/bitstream/handle/10665/255016/9789241565455-eng.pdf
5 Chen CJ, Iloeje UH, Yang Hwai-I. Long-term outcomes in hepatitis B: the REVEAL-HBV study. Clinics in Liver Disease. 2007 Nov 1; 11 (4):797-816, viii. https://pubmed.ncbi.nlm.nih.gov/17981229 https://doi.org/10.1016/j.cld.2007.08.005 PMid:17981229
6 Zhang HW, Yin JH, Li YT, Li CZ, Ren H, Gu CY, et al. Risk factors for acute hepatitis B and its progression to chronic hepatitis in Shanghai, China. Gut. 2008 Jul 30; 57 (12):1713-20. https://gut.bmj.com/content/57/12/1713 https://doi.org/10.1136/gut.2008.157149 PMid:18755887 PMCid:PMC2582333
7 Borgia G, Gentile I. Vertical transmission of hepatitis B virus: challenges and solutions. International Journal of Women's Health. 2014 Jun; 605. https://doi.org/10.2147/IJWH.S51138 PMid:24966696 PMCid:PMC4062549
8 Kumar M, Singh T, Sinha S. Chronic Hepatitis B Virus Infection and Pregnancy. Journal of Clinical and Experimental Hepatology. 2012 Dec; 2 (4):366-81. https://doi.org/10.1016/j.jceh.2012.09.001 PMid:25755458 PMCid:PMC3940289
9 Umar M, Hamama-tul-Bushra, Umar S, Khan HA. HBV Perinatal Transmission. International Journal of Hepatology.2013; 2013:875791. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3659463/ https://doi.org/10.1155/2013/875791 PMid:23738081 PMCid:PMC3659463
10 Yang J, Zeng X, Men Y, Zhao L. Elective caesarean section versus vaginal delivery for preventing mother to child transmission of hepatitis B virus - a systematic review. Virology Journal. 2008; 5(1):100. https://rd.springer.com/content/pdf/10.1186%2F1743-422X-5-100.pdf https://doi.org/10.1186/1743-422X-5-100 PMid:18755018 PMCid:PMC2535601
11Nelson NP, Jamieson DJ, Murphy TV. Prevention of Perinatal Hepatitis B Virus Transmission. Journal of the Pediatric Infectious Diseases Society. 2014 Sep 1; 3 (Suppl 1):S7-12. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4164184/ https://doi.org/10.1093/jpids/piu064 PMid:25232477 PMCid:PMC4164184
12 Chang MH. Chen DS. Prevention of Hepatitis B. Cold Spring Harbor Perspectives in Medicine. 2015 Mar 1; 5 (3): a021493 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4355249/ https://doi.org/10.1101/cshperspect.a021493 PMid:25732034 PMCid:PMC4355249
13 World Health Organization. Vaccine- preventable diseases: monitoring system. Global summary. Geneva: WHO. 2007.
14 Tripathi N, Mousa OY. Hepatitis B. PubMed. Treasure Island (FL): Stat Pearls Publishing; 2020. Available from: https://www.ncbi.nlm.nih.gov/books/NBK555945/
15 Thakur V, Guptan Rc, Kazim Sn, Malhotra V, Sarin Sk. Profile, spectrum and significance of HBV genotypes in chronic liver disease patients in the Indian subcontinent. Journal of Gastroenterology and Hepatology. 2002 Feb; 17 (2):165-70. https://doi.org/10.1046/j.1440-1746.2002.02605.x PMid:11966946
16 Li XM. Interruption of HBV intrauterine transmission: A clinical study. World Journal of Gastroenterology. 2003; 9 (7):1501. https://doi.org/10.3748/wjg.v9.i7.1501 PMid:12854150 PMCid:PMC4615491
17 Ayoub WS, Cohen E. Hepatitis B Management in the Pregnant Patient: An Update. Journal of Clinical and Translational Hepatology. 2016 Sep 28; 4 (3):241-7. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5075007/ https://doi.org/10.14218/JCTH.2016.00014 PMid:27777892 PMCid:PMC5075007
18 Puri P. Acute Exacerbation of Chronic Hepatitis B: The Dilemma of Differentiation from Acute Viral Hepatitis B. Journal of Clinical and Experimental Hepatology. 2013 Dec; 3 (4):301-12. https://doi.org/10.1016/j.jceh.2013.08.014 PMid:25755518 PMCid:PMC3940633
19 Xu Q. A randomized controlled clinical trial: Interruption of intrauterine transmission of hepatitis B virus infection with HBIG. World Journal of Gastroenterology. 2006; 12 (21):3434. https://doi.org/10.3748/wjg.v12.i21.3434 PMid:16733865 PMCid:PMC4087879
20 WHO, Guidelines for the Prevention, Care and Treatment of Persons with Chronic Hepatitis B Infection, WHO Guidelines Approved by the Guidelines Review Committee, Geneva, 2015.
21 Fung J, Lai CL, Seto WK, Yuen MF. Nucleoside/nucleotide analogues in the treatment of chronic hepatitis B. Journal of Antimicrobial Chemotherapy. 2011 Dec 1; 66 (12):2715-25. Available from: https://academic.oup.com/jac/article/66/12/2715/698352 https://doi.org/10.1093/jac/dkr388 PMid:21965435
22 Mast EE, Margolis HS, Fiore AE, Brink EW, Goldstein ST, Wang S, et al. A Comprehensive Immunization Strategy to Eliminate Transmission of Hepatitis B Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices (ACIP): Part 1: Immunization of Infants, Children, and Adolescents. Morbidity and mortality weekly report. 2005 Jan 1;
23Aslam A, Campoverde Reyes KJ, Malladi VR, Ishtiaq R, Lau DTY. Management of chronic hepatitis B during pregnancy. Gastroenterology Report. 2018 Nov 1; 6 (4):257-62. https://doi.org/10.1093/gastro/goy025 PMid:30430013 PMCid:PMC6225824
24 Dionne-Odom J, Tita AT, Silverman NS, #38: Hepatitis B in pregnancy screening, treatment, and prevention of vertical transmission, Am. J. Obstet. Gynecol. 214 (2016) 6-14. https://doi.org/10.1016/j.ajog.2015.09.100 PMid:26454123
25 Poordad F, Chee GM. Viral Resistance in Hepatitis B: Prevalence and Management. 2010 Feb 1; 12 (1):62-9. https://doi.org/10.1007/s11894-009-0088-1 PMid:20425486 PMCid:PMC2832900
26 Liang TJ. Hepatitis B: the virus and disease. Hepatology (Baltimore, Md). 2009 May; 49:S13-21. Available from: https://www.ncbi.nlm.nih.gov/pubmed/19399811 https://doi.org/10.1002/hep.22881 PMid:19399811 PMCid:PMC2809016

Published

15-12-2023
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How to Cite

1.
Sireesha V, Abhiram C, sneha Y, Mohiuddin S, Rama Rao T. Management and Elimination of mother-to-child transmission of hepatitis B virus: A therapeutical Approach. J. Drug Delivery Ther. [Internet]. 2023 Dec. 15 [cited 2025 Feb. 13];13(12):245-9. Available from: https://jddtonline.info/index.php/jddt/article/view/6334

How to Cite

1.
Sireesha V, Abhiram C, sneha Y, Mohiuddin S, Rama Rao T. Management and Elimination of mother-to-child transmission of hepatitis B virus: A therapeutical Approach. J. Drug Delivery Ther. [Internet]. 2023 Dec. 15 [cited 2025 Feb. 13];13(12):245-9. Available from: https://jddtonline.info/index.php/jddt/article/view/6334