title: Management of mother-to-child transmission of hepatitis B virus: Propositions and challenges.
abstract: Chronic hepatitis B virus (HBV) infection due to mother-to-child transmission (MTCT) during perinatal period remains an important global health problem. Despite standard passive-active immunoprophylaxis with hepatitis B immunoglobulin (HBIG) and hepatitis B vaccine in neonates, up to 9% of newborns still acquire HBV infection, especially these from hepatitis B e antigen (HBeAg) positive mothers. Management of HBV infection in pregnancy still need to draw careful attention because of some controversial aspects, including the failure of passive-active immunoprophylaxis in a fraction of newborns, the effect and necessity of periodical hepatitis B immunoglobulin (HBIG) injection to the mothers, the safety of antiviral prophylaxis with nucleoside/nucleotide analogs, the benefit of different delivery ways, and the safety of breastfeeding. In this review, we highlight these unsettled issues of preventive strategies in perinatal period, and we further aim to provide an optimal approach to the management of preventing MTCT of HBV infection.
authors.affiliation: Department of Infectious Diseases, Key Laboratory of Viral Hepatitis of Hunan, Xiangya Hospital, Central South University, Changsha 410008, China.
authors.forename: Panpan
authors.initials: P
authors.lastname: Yi
authors.affiliation: Department of Infectious Diseases, Key Laboratory of Viral Hepatitis of Hunan, Xiangya Hospital, Central South University, Changsha 410008, China.
authors.forename: Ruochan
authors.initials: R
authors.lastname: Chen
authors.affiliation: Department of Infectious Diseases, Key Laboratory of Viral Hepatitis of Hunan, Xiangya Hospital, Central South University, Changsha 410008, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Huang
authors.affiliation: Department of Infectious Diseases, Key Laboratory of Viral Hepatitis of Hunan, Xiangya Hospital, Central South University, Changsha 410008, China. Electronic address: rr_xy1234@126.com.
authors.forename: Rong-Rong
authors.initials: RR
authors.lastname: Zhou
authors.affiliation: Department of Infectious Diseases, Key Laboratory of Viral Hepatitis of Hunan, Xiangya Hospital, Central South University, Changsha 410008, China. Electronic address: xgfan@hotmail.com.
authors.forename: Xue-Gong
authors.initials: XG
authors.lastname: Fan
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use; D001942:Breast Feeding / Q000009:adverse effects; D002648:Child; D019468:Disease Management; D005260:Female; D006509:Hepatitis B / Q000188:drug therapy* / Q000276:immunology / Q000635:transmission* / Q000821:virology; D006515:Hepatitis B virus / Q000502:physiology*; D019694:Hepatitis B, Chronic / Q000188:drug therapy / Q000635:transmission / Q000821:virology; D006801:Humans; D007136:Immunoglobulins / Q000008:administration & dosage / Q000276:immunology; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control; D011247:Pregnancy
chemical_list: D000998:Antiviral Agents; D007136:Immunoglobulins; C045213:hepatitis B hyperimmune globulin
keywords: Antiviral therapy; Breastfeeding; Hepatitis B virus; Immunoprophylaxis; Mother to child transmission