Chronic viral hepatitis B and D in pregnant women: course and outcomes (review)

Hepatitis B is most common among young people, which is explained by the ways of infection – parenteral, sexual and vertical. Mother-to-child transmission is the main route of infection for children in areas where the hepatitis B virus (HBV) is endemic.The available current data on the course and outcomes of chronic viral hepatitis B are contradictory in pregnant women. Some authors argue that the exacerbation of chronic hepatitis B is more common in the first and third trimesters in pregnant women, and with an increase in gestation, there is a deterioration in liver function and an increased risk of fulminant liver failure. Other researchers note a more severe course in the second half of pregnancy or in the first months after delivery.High replication of the virus increases the frequency of gestational diabetes mellitus, hemostatic disorders, the threat of termination of pregnancy, gestosis, fetoplacental insufficiency, risk of bleeding in childbirth, premature birth, untimely discharge of amniotic fluid, and the birth of premature babies.Children become chronic carriers of HBsAd in neonatal hepatitis. These findings suggest that transplacental infection before birth may be a mechanism contributing to higher rates of failed prevention in newborns born to women with a high viral load.We could not find data on the features of the course and outcomes of viral hepatitis D in pregnant women in the available sources,. At the same time, it is known that mixed infection is more severe.Polymorphisms of genes associated with the regulation of the state of the vascular wall can have a significant impact on the course of infection.The high prevalence of hepatitis D infection in different parts of the world indicates the need for a comprehensive study of this disease, followed by the development of special programs for the prevention, early diagnosis and treatment of hepatitis B and D in pregnant women.

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THE TACTICS OF ANTIVIRAL THERAPY FOR CHRONIC VIRAL HEPATITIS B IN PREGNANT WOMEN

Technology transfer innovative solutions in medicine ◽

10.21303/2585-663.2020.001478 ◽

2020 ◽

pp. 14-16

Author(s):

Yuliia Mudra

Keyword(s):

Hepatitis B Virus ◽

Hepatitis B ◽

Pregnant Women ◽

Viral Hepatitis ◽

Antiviral Therapy ◽

Late Pregnancy ◽

Chronic Viral Hepatitis ◽

Sharp Drop ◽

B Virus ◽

Viral Hepatitis B

The aim of the study. Analysis of tactics of antiviral therapy for chronic viral hepatitis b in pregnant women. Methods. Theoretical analysis of scientific literature; analysis and generalization. Statistics and comparisons. Classification of theoretical material and development of recommendations. Research results. Today, there are about 2 billion people in the world ill with a chronic infection caused by the hepatitis B virus, 350 million of whom suffer from chronic hepatitis B, and most are asymptomatic carriers of the Australian antigen (HBsAg). Up to 50 % of all new cases of hepatitis B virus infection are due to vertical infection. Despite the lack of increase in viral load during pregnancy, alanine aminotransferase tends to increase in late pregnancy and in the postpartum period. A sharp drop in postpartum corticosteroids may create favourable conditions for hepatitis B virus activation. It is emphasized that the current treatment of hepatitis B virus includes the use of antiviral drugs, where Peg-IFN is absolutely contraindicated in pregnancy, lamivudine and entecavir are classified by the FDA as category C, and tenofovir and telbivudine are classified as category B. During pregnancy, it is recommended to use mainly category B drugs. Conclusions. The use of antiviral therapy in combination with immunoprophylaxis of new-borns is the optimal strategy for implementation as a universal program, as the success of such an intervention can make a significant contribution to achieving the ultimate goal of global elimination of hepatitis B virus.

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Trends for incidence of chronic hepatitis B monoinfection and chronic hepatitis B+D co-infection in the Kyrgyz Republic for the period of 2010-2012

Kazan medical journal ◽

10.17816/kmj2005 ◽

2014 ◽

Vol 95 (6) ◽

pp. 921-924 ◽

Cited By ~ 1

Author(s):

K A Nogoybaeva ◽

S T Tobokalova ◽

K T Kasymbekova ◽

G M Zairova

Keyword(s):

Chronic Hepatitis ◽

Hepatitis B ◽

Viral Hepatitis ◽

Chronic Hepatitis B ◽

Medical Information ◽

Chronic Viral Hepatitis ◽

Kyrgyz Republic ◽

Hepatitis D ◽

Viral Hepatitis B ◽

Epidemiological Situation

Aim. To assess the trends for the epidemiological situation of chronic hepatitis B monoinfection and chronic hepatitis B+D co-infection in the Kyrgyz Republic for the period of 2010-2012 for the development of anti-epidemic measures depending on the intensity of the process. Methods. The analysis of a database of national reporting forms on the treated cases of chronic viral hepatitis B monoinfection and chronic hepatitis B+D co-infection in primary health care units, cumulated by Republican Medical Information Center of the Ministry of Healthcare of the Kyrgyz Republic for the period of 2010-2012 was performed. Results. The incidence of chronic viral hepatitis D is identical to that of chronic viral hepatitis B (23 and 21 per 100 000 of population respectively) in the Kyrgyz Republic. Over the period of 2010-2012 the high level of total chronic hepatitis B incidence was reported in the northern part of the country (the Issyk-Kul region, 71 per 100 000, and chronic hepatitis D - in the southern part of the country (Osh, 62 per 100 000 of population). Statistically significant increase in the incidence of chronic hepatitis B in almost all regions of the country was recorded whereas only an upward trend was revealed in chronic hepatitis D incidence. Conclusion. Separate registration of patients with chronic viral hepatitis B and D in the Kyrgyz Republic starting from 2010 allowed evaluating the trends for the epidemiological situation of these diseases in different areas and developing preventive and anti-epidemic measures in regions of Kyrgyz Republic.

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