title: Hepatitis B in pregnancy.
abstract: OBJECTIVE
  Vertical transmission of the hepatitis B virus (HBV) is the commonest mode of infection and can be prevented with immunoprophylaxis of the infant and antiviral therapy in the mother. Our aim was to review a cohort of subjects with HBV in pregnancy to determine the prevalence of active disease or high HBV-DNA levels that required treatment to prevent transmission, and to review the management of mothers and infants.
  
  
  METHODS
  A retrospective case-note review was conducted of all the HBV-infected pregnant women and their infants who attended the Newcastle obstetric services from 2007 to 2011.
  
  
  RESULTS
  There were 113 pregnancies in 81 women (median age 28 years; 15% hepatitis B e antigen (HBeAg) positive) during 2007-11. 71% of mothers were first diagnosed with HBV during pregnancy. The mothers were born in 28 different countries. 69% of mothers had an HBV-DNA level less than 2000 IU/mL and 13% had HBV-DNA levels greater than 1.0×107IU/mL so would be eligible for antiviral therapy to prevent transmission to the infant. 9% had active eAg-positive HBV and 3% had active eAg-negative HBV requiring treatment. All infants born to HBeAg-positive mothers received hepatitis B immunoglobulin (HBIG) appropriately and 76% of infants received a full HBV vaccination course. One infant born to an HBeAg-negative mother was hepatitis B surface antigen positive 1 year post-delivery.
  
  
  CONCLUSIONS
  One in six women had active HBV requiring treatment or high HBV-DNA levels that would benefit from antiviral treatment to reduce the transmission risk. HBIG was administered appropriately but completion of the vaccination course was suboptimal.
authors.affiliation: Liver Unit , Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust , Newcastle upon Tyne , UK.
authors.forename: Jessica Katharine
authors.initials: JK
authors.lastname: Dyson
authors.affiliation: Health Protection Agency , Newcastle upon Tyne , UK.
authors.forename: Julia
authors.initials: J
authors.lastname: Waller
authors.affiliation: Department of Obstetrics , Royal Victoria Infirmary, Newcastle Upon Tyne Hospitals NHS Trust , Newcastle upon Tyne , UK.
authors.forename: Andrena
authors.initials: A
authors.lastname: Turley
authors.affiliation: Department of Obstetrics , Royal Victoria Infirmary, Newcastle Upon Tyne Hospitals NHS Trust , Newcastle upon Tyne , UK.
authors.forename: Enid
authors.initials: E
authors.lastname: Michael
authors.affiliation: Health Protection Agency , Newcastle upon Tyne , UK ; Institute of Cellular Medicine, Newcastle University , Newcastle upon Tyne , UK.
authors.forename: Samuel
authors.initials: S
authors.lastname: Moses
authors.affiliation: Health Protection Agency , Newcastle upon Tyne , UK ; Institute of Cellular Medicine, Newcastle University , Newcastle upon Tyne , UK.
authors.forename: Manoj
authors.initials: M
authors.lastname: Valappil
authors.affiliation: Liver Unit , Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust , Newcastle upon Tyne , UK ; Institute of Cellular Medicine, Newcastle University , Newcastle upon Tyne , UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Hudson
authors.affiliation: Liver Unit , Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust , Newcastle upon Tyne , UK ; Institute of Cellular Medicine, Newcastle University , Newcastle upon Tyne , UK.
authors.forename: Margaret
authors.initials: M
authors.lastname: Bassendine
authors.affiliation: Liver Unit , Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust , Newcastle upon Tyne , UK ; Institute of Cellular Medicine, Newcastle University , Newcastle upon Tyne , UK.
authors.forename: Stuart
authors.initials: S
authors.lastname: McPherson
keywords: ANTIVIRAL THERAPY; CHRONIC VIRAL HEPATITIS; HEPATITIS B; LIVER DISEASE IN PREGNANCY