title: Prophylaxis of vertical HBV infection.
abstract: BACKGROUND
  An appropriate management of HBV infection is the best strategy to finally reduce the total burden of HBV infection. Mother-to-child transmission (MTCT) is responsible for more than one third of chronic HBV infections worldwide. Because HBV infection in infancy or early childhood often leads to chronic infection, appropriate prophylaxis and management of HBV in pregnancy is crucial to prevent MTCT.
  
  
  METHODS
  The prevention of HBV vertical transmission is a complex task and includes: universal HBV screening of pregnant women, administration of antivirals in the third trimester of pregnancy in women with high viral load and passive-active HBV immunoprophylaxis with hepatitis B vaccine and hepatitis B immune globulin in newborns of all HBV infected women.
  
  
  CONCLUSIONS
  Universal screening of pregnant women for HBV infection, early identification of HBV DNA level in HBV-infected mothers, maternal treatment with class B according to FDA antivirals and passive/active anti-HBV immunoprophylaxis to newborns of HBV-positive mothers are crucial strategies for reducing vertical HBV transmission rates. Consideration of caesarean section in order to reduce the risk of vertical HBV transmission should be recommend in HBV infected pregnant women with high viral load despite antiviral therapy or when the therapy in the third trimester of pregnancy is not available.
authors.affiliation: a Department of Pediatric Infectious Diseases and Hepatology, Faculty of Medicine, Collegium Medicum Bydgoszcz , Nicolaus Copernicus University , Toruń , Poland.
authors.forename: Malgorzata
authors.initials: M
authors.lastname: Pawlowska
authors.affiliation: a Department of Pediatric Infectious Diseases and Hepatology, Faculty of Medicine, Collegium Medicum Bydgoszcz , Nicolaus Copernicus University , Toruń , Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Pniewska
authors.affiliation: a Department of Pediatric Infectious Diseases and Hepatology, Faculty of Medicine, Collegium Medicum Bydgoszcz , Nicolaus Copernicus University , Toruń , Poland.
authors.forename: Malgorzata
authors.initials: M
authors.lastname: Pilarczyk
authors.affiliation: b Department of Infectious Diseases and Hepatology, Faculty of Medicine, Collegium Medicum Bydgoszcz , Nicolaus Copernicus University , Toruń , Poland.
authors.forename: Dorota
authors.initials: D
authors.lastname: Kozielewicz
authors.affiliation: c Centre For Modern Interdisciplinary Technologies , Nicolaus Copernicus University , Toruń , Poland.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Domagalski
mesh_terms: D000998:Antiviral Agents / Q000008:administration & dosage / Q000627:therapeutic use; D004279:DNA, Viral / Q000302:isolation & purification; D005260:Female; D017325:Hepatitis B Vaccines / Q000008:administration & dosage; D019694:Hepatitis B, Chronic / Q000175:diagnosis / Q000517:prevention & control* / Q000635:transmission; D006801:Humans; D007136:Immunoglobulins / Q000008:administration & dosage; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008403:Mass Screening / Q000379:methods; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy* / Q000821:virology; D011263:Pregnancy Trimester, Third
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral; D017325:Hepatitis B Vaccines; D007136:Immunoglobulins; C045213:hepatitis B hyperimmune globulin
keywords: Vertical HBV infection; antivirals; elective cesarean section; prophylaxis; vaccine + HBIG