title: Managing HBV in pregnancy. Prevention, prophylaxis, treatment and follow-up: position paper produced by Australian, UK and New Zealand key opinion leaders.
abstract: Hepatitis B during pregnancy presents unique management issues for both the mother and fetus. These include the lack of a current cohesive strategy for treatment and follow-up of mothers and their babies; the uncertain risk of postpartum HBV flares; the lack of randomised trial data on the safety and efficacy of antiviral treatment in pregnancy; the lack of head-to-head studies comparing different antivirals in pregnancy; and the lack of epidemiologic information regarding infection across different populations globally. This position paper provides a comprehensive review of the management of women with HBV infection prior to conception, throughout each stage of pregnancy and postpartum, as well as recommendations and clinical approaches for the follow-up of children born to infected mothers, based on available evidence in the literature and recommendations from international experts. Prevention of perinatal transmission is an important component of global efforts to reduce the burden of chronic HBV since vertical transmission is responsible for most of the chronic infection worldwide.
authors.affiliation: St. Vincent's Hospital, Fitzroy, Australia Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Kumar
authors.initials: K
authors.lastname: Visvanathan
authors.affiliation: Institute of Liver and Digestive Health, Royal Free Hospital London, London, UK.
authors.forename: Geoff
authors.initials: G
authors.lastname: Dusheiko
authors.affiliation: Department of Infectious Diseases and Department of Obstetrics and Gynaecology Monash Health, The Alfred Hospital, The Royal Women's Hospital, Melbourne, Victoria, Australia.
authors.forename: Michelle
authors.initials: M
authors.lastname: Giles
authors.affiliation: Department of Gastroenterology, Box Hill Hospital, Melbourne, Victoria, Australia.
authors.forename: May-Ling
authors.initials: ML
authors.lastname: Wong
authors.affiliation: Liver Addiction Research Unit and Storr Liver Unit, Westmead Millennium Institute, University of Sydney and Westmead Hospital, Westmead, New South Wales, Australia Drug Health Western Sydney Local Health District, Westmead, New South Wales, Australia.
authors.forename: Nghi
authors.initials: N
authors.lastname: Phung
authors.affiliation: Department of Obstetrics and Gynecology, University of Melbourne, Melbourne, Victoria, Australia Department of Perinatal Medicine, Mercy Hospital for Women, Melbourne, Victoria, Australia.
authors.forename: Susan
authors.initials: S
authors.lastname: Walker
authors.affiliation: Department of Gastroenterology and Hepatology, Monash Health, Melbourne, Victoria, Australia.
authors.forename: Suong
authors.initials: S
authors.lastname: Le
authors.affiliation: Department of Hepatology, National University Health System, Singapore, Singapore.
authors.forename: Seng Gee
authors.initials: SG
authors.lastname: Lim
authors.affiliation: Liver Transplant Unit, Auckland City Hospital Auckland, Auckland, New Zealand.
authors.forename: Ed
authors.initials: E
authors.lastname: Gane
authors.affiliation: Gastroenterology and Hepatology Department, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.
authors.forename: Meng
authors.initials: M
authors.lastname: Ngu
authors.affiliation: Department of Gastroenterology, Royal Children's Hospital, Melbourne, Victoria, Australia Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia Murdoch Childrens Research Institute, Parkville, Victoria, Australia.
authors.forename: Winita
authors.initials: W
authors.lastname: Hardikar
authors.affiliation: Department of Infectious Diseases, Royal Melbourne Hospital, Melbourne, Victoria, Australia Victorian Infectious Disease Reference Laboratory, Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia.
authors.forename: Ben
authors.initials: B
authors.lastname: Cowie
authors.affiliation: Victorian Infectious Disease Reference Laboratory, Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia.
authors.forename: Scott
authors.initials: S
authors.lastname: Bowden
authors.affiliation: AW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, Camperdown, Australia.
authors.forename: Simone
authors.initials: S
authors.lastname: Strasser
authors.affiliation: Liverpool Hospital, Sydney, New South Wales, Australia Department of Medicine, University of NSW, Sydney, New South Wales, Australia.
authors.forename: Miriam
authors.initials: M
authors.lastname: Levy
authors.affiliation: Department of Infectious Diseases, Royal Melbourne Hospital, Melbourne, Victoria, Australia.
authors.forename: Joe
authors.initials: J
authors.lastname: Sasaduesz
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use; D001942:Breast Feeding; D036861:Delivery, Obstetric / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006509:Hepatitis B / Q000175:diagnosis / Q000188:drug therapy* / Q000517:prevention & control* / Q000635:transmission; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control; D049590:Postpartum Period; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis / Q000188:drug therapy* / Q000517:prevention & control*; D011296:Prenatal Diagnosis; D012017:Referral and Consultation; D014611:Vaccination
chemical_list: D000998:Antiviral Agents
keywords: HEPATITIS B; IMMUNOLOGY