title: Evaluation of hepatitis B virus transmission and antiviral therapy among hepatitis B surface antigen-positive pregnant women.
abstract: OBJECTIVE
  The aim of the present study was to assess the potential risk of hepatitis B virus (HBV) vertical transmission among Turkish parturient women and to evaluate the efficacy and safety of antiviral agents.
  
  
  METHODS
  Data were collected retrospectively from 114 HBV-infected pregnant women and their infants in eight health institutions in Turkey.
  
  
  RESULTS
  The baseline characteristics of the women were: mean age, 28.3 ± 5.2 years; alanine aminotransferase, 57.4 ± 139.0 U/L; aspartate aminotransferase, 56.6 ± 150.0 U/L; and HBV DNA, 8.3 × 10(7) ± 2.6 × 10(8) copies/mL. Family history of HBV infection was detected in 53.5% (n = 61). In total, 60 (52.6%) pregnant women received tenofovir (60.0%), lamivudine (33.3%) or telbivudine (6.7%) therapy at the median gestational age of 22.2 ± 8.5 (1-36) weeks. All infants were vaccinated and hepatitis B immune globulin was administered, with 81 of them (71.1%) available for follow-up. After completion of HBV vaccination course, 71 (87.7%) infants had protective anti-HBs levels, three (3.7%) were hepatitis B surface antigen-positive, and seven (8.6%) were hepatitis B surface antigen-negative with nonprotective anti-HBs levels. Five of the infants had low gestational birthweight but no other birth defects were observed.
  
  
  CONCLUSIONS
  According to our results, viral load may not be the only effecting factor for transmission of HBV to children of infected mothers. Pregnant women with high viral load should be followed-up closely during pregnancy. They should begin to take tenofovir or telbivudine, which are category B drugs for pregnancy, at the beginning of the third trimester at the latest. We need new treatment strategies; and close follow-up of mothers and children is another important issue.
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Harran University, Sanliurfa, Turkey.
authors.forename: Suda
authors.initials: S
authors.lastname: Tekin Koruk
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey.
authors.forename: Ayse
authors.initials: A
authors.lastname: Batirel
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Izmir Tepecik Training and Research Hospital, Izmir, Turkey.
authors.forename: Sukran
authors.initials: S
authors.lastname: Kose
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey.
authors.forename: Sila
authors.initials: S
authors.lastname: Cetin Akhan
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
authors.forename: Bilgehan
authors.initials: B
authors.lastname: Aygen
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Ankara Training and Research Hospital, Ankara, Turkey.
authors.forename: Necla
authors.initials: N
authors.lastname: Tulek
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Ankara Training and Research Hospital, Ankara, Turkey.
authors.forename: Çigdem
authors.initials: Ç
authors.lastname: Hatipoglu
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Ankara Training and Research Hospital, Ankara, Turkey.
authors.forename: Cemal
authors.initials: C
authors.lastname: Bulut
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
authors.forename: Orhan
authors.initials: O
authors.lastname: Yıldız
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Kartal Yavuz Selim Training and Research Hospital, Istanbul, Turkey.
authors.forename: Cahide
authors.initials: C
authors.lastname: Sacligil
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Abant Izzet Baysal University, Bolu, Turkey.
authors.forename: Fatma
authors.initials: F
authors.lastname: Sirmatel
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey.
authors.forename: Elif
authors.initials: E
authors.lastname: Altunok
mesh_terms: D000293:Adolescent; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D005260:Female; D006509:Hepatitis B / Q000188:drug therapy / Q000635:transmission* / Q000821:virology; D006514:Hepatitis B Surface Antigens / Q000097:blood*; D006801:Humans; D018445:Infectious Disease Transmission, Vertical; D011247:Pregnancy; D012189:Retrospective Studies
chemical_list: D000998:Antiviral Agents; D006514:Hepatitis B Surface Antigens
keywords: antiviral therapy; hepatitis B; perinatal transmission; pregnancy