Prevention of maternal-to-child transmission of hepatitis B: a narrative review

Mimi TY SETO; Ka-Wang CHEUNG

doi:10.12809/hkjgom.21.1.07

Authors

Mimi TY SETO
Ka-Wang CHEUNG

DOI:

https://doi.org/10.12809/hkjgom.21.1.07

Keywords:

Antiviral agents, Hepatitis B virus, Infectious disease transmission, vertical, Pregnancy, Vaccination

Abstract

Chronic hepatitis B virus (HBV) infection can result in cirrhosis and hepatocellular carcinoma. Most chronic HBV infections are caused by mother-to-child transmission during the perinatal period. The World Health Organization aims to eradicate HBV globally by 2030. Hong Kong has implemented a wide range of preventive strategies to decrease maternal-to-child transmission. This review summarises the experience in Hong Kong and the current recommendations to prevent HBV vertical transmission.

References

WHO. Hepatitis B: World Health Organization; 2020. Available from: https://www.who.int/news-room/fact-sheets/detail/hepatitis-b.

Lam PK, Poon S. Surveillance of Viral Hepatitis in Hong Kong - 2018 Report. Viral Hepatitis Control Office; 2019.

Liu KSH, Seto WK, Lau EHY, et al. A territory-wide prevalence study on blood-borne and enteric viral hepatitis in Hong Kong. J Infect Dis 2019;219:1924-33.

Department of Health, Hong Kong SAR. Hepatitis Elimination. Available from: https://www.hepatitis.gov.hk/english/hepatitis_elimination/maternal_transmission_of_hepatitis_b.html.

Hutin Y, Desai S, Bulterys M. Preventing hepatitis B virus infection: milestones and targets. Bull World Health Organ 2018;96:443-443a.

World Health Organization. Global health sector strategy on viral hepatitis 2016-2021, towards ending viral hepatitis. Available from: https://apps.who.int/iris/bitstream/handle/10665/246177/WHO-HIV-2016.06-eng.pdf?sequence=1.

World Health Organization. Prevention of mother-to-child transmission of hepatitis B virus: guidelines on antiviral prophylaxis in pregnancy2020. Available from: https://www.who.int/publications/i/item/978-92-4-000270-8.

Chung PW, Suen SH, Chan OK, Lao TH, Leung TY. Awareness and knowledge of hepatitis B infection and prevention and the use of hepatitis B vaccination in the Hong Kong adult Chinese population. Chin Med J (Engl) 2012;125:422-7.

Chan OK, Lao TT, Suen SS, Lau TK, Leung TY. Knowledge on hepatitis B infection among pregnant women in a high endemicity area. Patient Educ Couns 2011;85:516-20.

Cheung KW, Seto MTY, Wong D, et al. Pattern and predictors of medical care received by hepatitis B carriers during pregnancy and after delivery. Public Health 2019;168:36-42.

Wong VC, Ip HM, Reesink HW, et al. Prevention of the HBsAg carrier state in newborn infants of mothers who are chronic carriers of HBsAg and HBeAg by administration of hepatitis-B vaccine and hepatitis-B immunoglobulin. Double-blind randomised placebo-controlled study. Lancet 1984;1:921-6.

Huang H, Xu C, Liu L, et al. Increased protection of earlier use of immunoprophylaxis in preventing perinatal transmission of hepatitis B virus. Clin Infect Dis 2020:ciaa898.

Jourdain G, Ngo-Giang-Huong N, Harrison L, et al. Tenofovir versus placebo to prevent perinatal transmission of hepatitis B. N Engl J Med 2018;378:911-23.

Cheung KW, Lao TT. Hepatitis B - Vertical transmission and the prevention of mother-to-child transmission. Best Pract Res Clin Obstet Gynaecol 2020;68:78-88.

Cheung KW, Seto MT, Wong SF. Towards complete eradication of hepatitis B infection from perinatal transmission: review of the mechanisms of in utero infection and the use of antiviral treatment during pregnancy. Eur J Obstet Gynecol Reprod Biol 2013;169:17-23.

Cheung KW, Seto MTY, Kan ASY, et al. Immunoprophylaxis failure of infants born to hepatitis B carrier mothers following routine vaccination. Clin Gastroenterol Hepatol 2018;16:144-5.

Funk AL, Lu Y, Yoshida K, et al. Efficacy and safety of antiviral prophylaxis during pregnancy to prevent mother-to-child transmission of hepatitis B virus: a systematic review and meta-analysis. Lancet Infect Dis 2021;21:70-84.

Hyun MH, Lee YS, Kim JH, et al. Systematic review with meta-analysis: the efficacy and safety of tenofovir to prevent mother-to-child transmission of hepatitis B virus. Aliment Pharmacol Ther 2017;45:1493-505.

Hu YH, Liu M, Yi W, Cao YJ, Cai HD. Tenofovir rescue therapy in pregnant females with chronic hepatitis B. World J Gastroenterol 2015;21:2504-9.

Pan CQ, Duan Z, Dai E, et al. Tenofovir to prevent hepatitis B transmission in mothers with high viral load. N Engl J Med 2016;374:2324-34.

Cheung KW, Seto MTY, Ng EHY. Tenofovir to prevent perinatal transmission of hepatitis B. N Engl J Med 2018;378:2349-50.

Terrault NA, Lok ASF, McMahon BJ, et al. Update on prevention, diagnosis, and treatment of chronic hepatitis B: AASLD 2018 hepatitis B guidance. Hepatology 2018;67:1560-99.

European Association for the Study of the Liver. EASL 2017 Clinical Practice Guidelines on the management of hepatitis B virus infection. J Hepatol 2017;67:370-98.

Terrault NA, Levy MT, Cheung KW, Jourdain G. Viral hepatitis and pregnancy. Nat Rev Gastroenterol Hepatol 2020.

Yi W, Pan CQ, Hao J, et al. Risk of vertical transmission of hepatitis B after amniocentesis in HBs antigen-positive mothers. J Hepatol 2014;60:523-9.

Han Z, Zhang Y, Bai X, Yin Y, Xu C, Hou H. Mother-to-child transmission of hepatitis B virus after amniocentesis: a retrospective matched cohort study. Prenat Diagn 2019;39:431-40.

Cheung KW, Seto MTY, So PL, et al. The effect of rupture of membranes and labour on the risk of hepatitis B vertical transmission: prospective multicentre observational study. Eur J Obstet Gynecol Reprod Biol 2019;232:97-100.

Chen HL, Cai JY, Song YP, Zha ML, Qin G. Vaginal delivery and HBV mother to child transmission risk after immunoprophylaxis: a systematic review and a metaanalysis. Midwifery 2019;74:116-25.

Cheung KW, Seto MTY, So PL, et al. Optimal timing of hepatitis B virus DNA quantification and clinical predictors for higher viral load during pregnancy. Acta Obstet Gynecol Scand 2019;98:1301-6.

Ghany MG, Feld JJ, Chang KM, et al. Serum alanine aminotransferase flares in chronic hepatitis B infection: the good and the bad. Lancet Gastroenterol Hepatol 2020;5:406-17.

Hu X, Wang L, Xu F. Guides concerning tenofovir exposure via breastfeeding: a comparison of drug dosages by developmental stage. Int J Infect Dis 2019;87:8-12.

Terrault NA, Bzowej NH, Chang KM, et al. AASLD guidelines for treatment of chronic hepatitis B. Hepatology 2016;63:261-83.

Visvanathan K, Dusheiko G, Giles M, et al. Managing HBV in pregnancy. Prevention, prophylaxis, treatment and followup: position paper produced by Australian, UK and New Zealand key opinion leaders. Gut 2016;65:340-50.

Xiao F, Lan A, Mo W. Breastfeeding from mothers carrying HBV would not increase the risk of HBV infection in infants after proper immunoprophylaxis. Minerva Pediatr 2020;72:109-15.