Hepatitis B Virus Infection In Pregnancy

Hepatitis B viru（sHBV）infection has been a threat to human healthand life. Approximately400million people are infected with HBVworldwide and50%of them have acquired their infection throughmother to infant vertical transmission(MTVT）,over90%of perinatallyacquired infections progress to chronic HBV infection.HBV infection hadan adverse effect on pregnancy outcome(such as: gestational diabetesmellitus, antepartum hemorrhage,threatened premature labor,low bodyweight infants,etal).Thus, a comprehensive understanding and effectivetreatment of hepatitis B virus infection during pregnancy can significantlyreduce HBV infection and the incidence of adverse pregnancy outcomes.For HBsAg positive pregnant women，with higher HBV-DNA leveland hepatitis activity (ALT>2upper limit of normal), HBV-DNA>105copies/ml or accompanied by hepatic fibrosis/liver cirrhosis, antiviraltherapy should be administered during early pregnancy. For patients withHBV DNA>107copies/ml or prior delivery history of HBV-positiveinfants and HBV DNA>106copies/ml, antiviral therapy (LAM, TDF or LDT)should be given at28-30wk until4wk after delivery, then it should be determined whether the above therapy is to be continued on the basis of thepatient’s condition. Most guidelines now recommend that infants born toHBsAg-positive women should receive both HBIG and hepatitis B vaccinewithin24h of birth, preferably in the delivery room.this prophylaxis is besteffective in blocking HBV maternal transmission.Hepatitis B virusinfection is not a major factor in the selective cesarean section.In theabsence of cracked or bleeding nipples, breastfeeding of properlyimmunized infants is encouraged.But we still have many questions about hepatitis B virus infection inpregnancy，such as：Is hepatitis B virus transmitted via the male germ line?Is antiviral therapy in the first trimester safe？ Can hepatitis Bimmunoglobulin in the third trimester block intrauterine infection? et al.