Hepatitis B virus infection
Journal
Seminars in Fetal and Neonatal Medicine
Journal Volume
12
Journal Issue
3
Pages
160-167
Date Issued
2007
Author(s)
Abstract
Hepatitis B virus (HBV) infection is a worldwide health problem and may cause acute, fulminant, chronic hepatitis, liver cirrhosis, or hepatocelullar carcinoma (HCC). Infection with HBV in infancy or early childhood may lead to a high rate of persistent infection (25-90%), while the rates are lower if infection occurs during adulthood (5-10%). In most endemic areas, infection occurs mainly during early childhood and mother-to-infant transmission accounts for approximately 50% of the chronic infection cases. Hepatitis B during pregnancy does not increase maternal mortality or morbidity or the risk of fetal complications. Approximately 90% of the infants of HBsAg carrier mothers with positive hepatitis B e-antigen (HBeAg) will become carriers if no immunoprophylaxis is given. Transplacental HBeAg may induce a specific non-responsiveness of helper T cells and HBcAg. Spontaneous HBeAg seroconversion to anti-HBe may develop with time but liver damage may occur during the process of the immune clearance of HBV and HBeAg. Mother-to-infant transmission of HBV from HBeAg negative but HBsAg positive mothers is the most important cause of acute or fulminant hepatitis B in infancy. Although antiviral agents are available to treat and avoid the complications of chronic hepatitis B, prevention of HBV infection is the best way for control. Screening for maternal HBsAg with/without HBeAg, followed by three to four doses of HBV vaccine in infancy and hepatitis B immunoglobulin (HBIG) within 24 h of birth is the most effective way to prevent HBV infection. In areas with a low prevalence of HBV infection or with limited resources, omitting maternal screening but giving three doses of HBV vaccine universally in infancy can also produce good protective efficacy. The first universal HBV immunisation programme in the world was launched in Taiwan 22 years ago. HBV infection rates, chronicity rates, incidence of HCC and incidence of fulminant hepatitis in children have been effectively reduced. ? 2007 Elsevier Ltd. All rights reserved.
Subjects
Chronic hepatitis B; Hepatitis B e antigen; Hepatitis B immunoglogulin; Hepatitis B vaccine; Hepatitis B virus; Mother-to-infant transmission
SDGs
Other Subjects
antivirus agent; hepatitis B antibody; hepatitis B vaccine; hepatitis B(e) antigen; interferon; lamivudine; placebo; clinical trial; drug efficacy; health care cost; helper cell; hepatitis; hepatitis B; Hepatitis B virus; human; immunization; immunological tolerance; incidence; infection control; liver cell carcinoma; liver injury; nonhuman; pregnancy; prevalence; recommended drug dose; review; seroconversion; vertical transmission; virus transmission; Antiviral Agents; Disease Transmission, Vertical; Female; Hepatitis B; Hepatitis B Vaccines; Humans; Infant, Newborn; Pregnancy; Pregnancy Complications, Infectious; Prenatal Diagnosis
Type
review