title: Individualized management of pregnant women with high hepatitis B virus DNA levels.
abstract: Hepatitis B is a major health concern in the Asia-Pacific region, and is endemic in China, Southeast Asia, and Africa. Chronic hepatitis B virus (HBV) infection may cause hepatic cirrhosis and liver cancer. It is estimated that there are more than 350 million chronic HBV carriers worldwide, of whom approximately one quarter will die of chronic hepatitis B-related liver diseases. HBV is transmitted horizontally through blood and blood products or by sexual transmission, and vertically from mother to infant. Perinatal infection is the predominant mode of transmission in countries with a high prevalence of hepatitis B surface antigen (HBsAg) carriage, and perinatal transmission leads to high rates of chronic infection. Therefore, it is important to prevent the mother-to-child transmission (MTCT) of HBV. Research has shown that pregnant women with high HBV DNA levels have an increased risk of MTCT. However, most of the obstetrics guidelines do not make a distinction between pregnant women with high HBV DNA levels and those who are HBsAg positive only. This review addresses the management of pregnant women with high levels of HBV viremia, in terms of antiviral therapy, use of hepatitis B immunoglobulin (HBIG), the combined application of hepatitis B vaccine and HBIG, choice of delivery mode and feeding practices.
authors.affiliation: Zhao Zhang, Zhe Li, Ying-Hua Wu, Xiao-Min Xiao, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Jinan University, Guangzhou 510632, Guangdong Province, China.
authors.forename: Zhao
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: Zhao Zhang, Zhe Li, Ying-Hua Wu, Xiao-Min Xiao, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Jinan University, Guangzhou 510632, Guangdong Province, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Chen
authors.affiliation: Zhao Zhang, Zhe Li, Ying-Hua Wu, Xiao-Min Xiao, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Jinan University, Guangzhou 510632, Guangdong Province, China.
authors.forename: Zhe
authors.initials: Z
authors.lastname: Li
authors.affiliation: Zhao Zhang, Zhe Li, Ying-Hua Wu, Xiao-Min Xiao, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Jinan University, Guangzhou 510632, Guangdong Province, China.
authors.forename: Ying-Hua
authors.initials: YH
authors.lastname: Wu
authors.affiliation: Zhao Zhang, Zhe Li, Ying-Hua Wu, Xiao-Min Xiao, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Jinan University, Guangzhou 510632, Guangdong Province, China.
authors.forename: Xiao-Min
authors.initials: XM
authors.lastname: Xiao
mesh_terms: D015415:Biomarkers / Q000097:blood; D004279:DNA, Viral / Q000097:blood*; D005260:Female; D017325:Hepatitis B Vaccines / Q000627:therapeutic use*; D006515:Hepatitis B virus / Q000187:drug effects* / Q000235:genetics / Q000472:pathogenicity; D019694:Hepatitis B, Chronic / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy* / Q000635:transmission / Q000821:virology; D006801:Humans; D007136:Immunoglobulins / Q000627:therapeutic use*; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D018579:Patient Selection; D011237:Predictive Value of Tests; D011247:Pregnancy; D011296:Prenatal Diagnosis; D012307:Risk Factors; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D015415:Biomarkers; D004279:DNA, Viral; D017325:Hepatitis B Vaccines; D007136:Immunoglobulins; C045213:hepatitis B hyperimmune globulin
keywords: Hepatitis B virus; Hepatitis B virus DNA; High level; Management; Pregnancy