Characterization and Statistical Modeling to Estimate Timing and Duration of Antiviral Therapy to Achieve Target HBV DNA ≤200,000 IU/ML at Delivery to Reduce Risk of Mother to Child Transmission (MTCT) in Pregnant Women with Chronic Hepatitis B (CHB)

2017 ◽  
Vol 152 (5) ◽  
pp. S1087
Author(s):  
Christine Y. Chang ◽  
Matthew S. Chang ◽  
Donghak Jeong ◽  
Natali Aziz ◽  
Daryl Lau ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Pregnant Women ◽  
Antiviral Therapy ◽  
Statistical Modeling ◽  
Chronic Hepatitis B ◽  
Hbv Dna ◽  
Child Transmission ◽  
Reduce Risk ◽  
Mother To Child

scholarly journals Acute-on-Chronic Liver Failure in Pregnant Patients with Chronic Hepatitis B: A Retrospective Observational Case Series Study

2020 ◽  
Vol 2020 ◽  
pp. 1-8 ◽  
Author(s):  
Shiwei Wang ◽  
Haofeng Xiong ◽  
Changling Luo ◽  
Hong Zhao ◽  
Ying Fan ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Liver Failure ◽  
Pregnant Women ◽  
Antiviral Therapy ◽  
Chronic Hepatitis B ◽  
Hbv Dna ◽  
Chronic Liver ◽  
Chronic Liver Failure ◽  
Transfusion Therapy

Background and Aims. Acute-on-chronic liver failure (ACLF) is common in patients with end-stage liver disease and chronic hepatitis B (CHB) or hepatitis B virus- (HBV-) related cirrhosis. To date, no uniform definition and management strategy are available for ACLF. Although a considerable number of studies on ACLF has been published, there are few reports on ACLF in pregnant women with CHB. This study retrospectively reviewed five patients who were diagnosed with ACLF during pregnancy in the past 10 years. We aimed at investigating their clinical characteristics, treatment, biochemical test results, and maternal and fetal outcomes. Results. Asthenia, anorexia, and jaundice were the main initial clinical manifestations in these patients during the second or third trimester of pregnancy. All patients received antiviral therapy. None of the pregnant women died after treatment. Patient #4 was treated with an artificial liver support system, and patients #2 and #5 underwent transfusion therapy. The acute insult in all patients was HBV DNA reactivation. Except for patient #3, who chose an actively induced vaginal delivery because of intrauterine fetal demise, the remaining four patients underwent a preterm delivery via a cesarean section. The four neonates were alive, although all were small for gestational age. Conclusion. Asthenia, anorexia, and jaundice during mid-late pregnancy should be immediately investigated. Before and during the pregnancy, hepatologists or obstetricians should actively screen pregnant women with CHB for HBV DNA status and alanine aminotransferase levels. Reactivation of HBV replication in pregnant women with CHB may lead to ACLF, especially in multiparous women. Once ACLF is diagnosed, antiviral therapy should be considered as soon as possible to protect maternal and fetal health.

Update in management of hepatitis B in pregnancy and prevention of mother to child hepatitis B transmission

2018 ◽  
Vol 1 (3) ◽  
pp. 1-8
Author(s):  
Naichaya Chamroonkul
Keyword(s):  
Chronic Hepatitis ◽  
Viral Load ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
High Viral Load ◽  
World Population ◽  
Hepatitis B Infection ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Mother To Child

Even with two decades of widespread using hepatitis B vaccination, chronic hepatitis B remains a major global health problem. In Thailand, the prevalence of chronic hepatitis B infection was down from 8 - 10% in last decade to 5% recently. Failure to control mother to child transmission is one of the important barriers to the total elimination of hepatitis B infection from world population. In the majority, vertical transmission can be prevented with a universal screening program, immunoprophylaxis by administration of hepatitis B vaccine and hepatitis B immunoglobulin (HBIg) for babies born to mothers with HBV. However, in mothers with a high viral load, the chance of immunoprophylaxis failure remains high. To date, there are standard recommendations by all international liver societies including AASLD, EASL and APASL suggest introducing an antiviral agent during the third trimester to CHB pregnant women with a high viral load. Previous US FDA pregnancy category B agents such as Tenofovir and Telbivudine are allowed through all trimesters of pregnancy and are effective for prevention of mother to child transmission. Breastfeeding for patients who receive antiviral agents can be allowed after a risk-benefit discussion with the patient and family.

Effect of Lowering HBV DNA Levels by Initial Antiviral Therapy Before Adding Immunomodulator on Treatment of Chronic Hepatitis B

2007 ◽  
Vol 102 (1) ◽  
pp. 96-104 ◽  
Author(s):  
Shiv Kumar Sarin ◽  
Ajit Sood ◽  
Manoj Kumar ◽  
Anil Arora ◽  
Deepak Amrapurkar ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Antiviral Therapy ◽  
Chronic Hepatitis B ◽  
Hbv Dna

scholarly journals INTENSIFICATION OF ANTIVIRAL THERAPY OF CHRONIC HEPATITIS B BY MEANS OF INTRADERMAL IMMUNIZATION WITH AUTOLEUKOCYTES

2020 ◽  
Vol 73 (10) ◽  
pp. 2156-2159
Author(s):  
Alexandr N. Zinchuk ◽  
Olga A. Golubovska ◽  
Borys A. Herasun ◽  
Andrii M. Zadorozhnyi ◽  
Oleksandr B. Herasun
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Antiviral Therapy ◽  
Chronic Hepatitis B ◽  
Venous Blood ◽  
Intradermal Injection ◽  
Hbv Dna ◽  
Nucleotide Analogue ◽  
Intradermal Immunization ◽  
Pcr Method

The aim: Was a trial of intradermal immunization with native autoleukocytes as a curative vaccine. Materials and methods: Thus, 3-shot series vaccination by means of intradermal injection of autoleukocytes with 30 – 40 days interval was conducted for patients who, in spite of continuous (at least 2 years) therapy with nucleotide analogue, experienced HBV DNA reproduction. For this procedure, 80 – 100 ml of a patient’s heparinized venous blood was being precipitated at the temperature 37оС for 120 – 140 minutes, after blood plasma was being centrifuged at 450g for 8 minutes. The precipitate was resuspended in 1 – 1.5 ml of blood serum and injected intradermally in the region of the back. Results: Viral load decreased in all patients even after single immunization; it was possible to achieve a negative result by ultrasensitive PCR method in 23.33% of patients in the group of patients who did not respond adequately to antiviral therapy. Conclusions: In patients with chronic hepatitis B, intradermal immunization with autoleukocytes has a significant impact on intensity of virus replication. It is confirmed by a considerable reduction of DNA HBV amount in patients, in whom antiviral therapy was stopped before immunization

scholarly journals Risk factors related to postpartum hepatic inflammation in pregnant women with chronic hepatitis B

2020 ◽  
Vol 48 (11) ◽  
pp. 030006052096643
Author(s):  
Lu Li ◽  
Huaibin Zou ◽  
Manman Xu ◽  
Shuang Li ◽  
Yunxia Zhu ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Liver Function ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Antiviral Therapy ◽  
Hbv Dna ◽  
Hepatic Inflammation

Objectives To investigate liver function after pregnancy in women with chronic hepatitis B virus (HBV) and factors related to postpartum abnormalities. Methods A total of 317 pregnant women were included in this study and 138 had an HBV DNA level. In this trial, the highest number and proportion of hepatitis B surface antigen-positive mothers with postpartum hepatic inflammation were at 1 month after delivery. Results Baseline liver function of postpartum women with hepatic inflammation was significantly higher than that in those before delivery. The rates of hepatitis B e-antigen (HBeAg)-positive status, baseline HBV DNA levels, gestational diabetes mellitus, and antiviral therapy during pregnancy were significantly higher in the hepatic inflammation group than in the control group. Among the 138 women who received antiviral therapy, 83 withdrew from antiviral therapy immediately after delivery and 55 continued antiviral therapy for at least 1 month after delivery. Multivariate logistic regression analysis showed that HBeAg-positivity and gestational diabetes mellitus were associated with hepatic inflammation after delivery. Postpartum hepatic inflammation occurred mostly at 1 month after delivery in pregnant women with HBV infection. Conclusions Close monitoring of women with HBV during pregnancy is required, especially for those who are HBeAg-positive and have gestational diabetes mellitus.

Sign in / Sign up

Export Citation Format

Share Document