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

Keywords: hepatitis B, antiviral therapy, pregnancy, lamivudine, entecavir, tenofovir, telbivudine, HBeAg, immunoprophylaxis, effects on the fetus

Abstract

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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Author Biography

Yuliia Mudra, Shupyk National Medical Academy of Postgraduate Education

Department of Obstetrics, Gynecology and Reproductology

 

References

Han, L., Zhang, H. W., Xie, J. X., Zhang, Q., Wang, H. Y., Cao, G. W. (2011). A meta-analysis of lamivudine for interruption of mother-to-child transmission of hepatitis B virus. World Journal of Gastroenterology, 17 (38), 4321–4333. doi: http://doi.org/10.3748/wjg.v17.i38.4321

Bogomolov, P. O., Matsievich, M. V., Kokina, K. Y., Voronkova, N. V., Kuz’mina, O. S., Bueverov, A. O. (2016). Chronic hepatitis b virus infection in pregnancy: strategies of antiviral therapy. Almanac of Clinical Medicine, 6 (40), 126–131. doi: http://doi.org/10.18786/2072-0505-2015-40-126-131

Han, G.-R., Cao, M.-K., Zhao, W., Jiang, H.-X., Wang, C.-M., Bai, S.-F. et. al. (2011). A prospective and open-label study for the efficacy and safety of telbivudine in pregnancy for the prevention of perinatal transmission of hepatitis B virus infection. Journal of Hepatology, 55 (6), 1215–1221. doi: http://doi.org/10.1016/j.jhep.2011.02.032

Gibb, D. M., Kizito, H., Russell, E. C., Chidziva, E., Zalwango, E. et. al. (2012). Pregnancy and Infant Outcomes among HIV-Infected Women Taking Long-Term ART with and without Tenofovir in the DART Trial. PLoS Medicine, 9 (5), e1001217. doi: http://doi.org/10.1371/journal.pmed.1001217

Bissinger, A. L., Fehrle, C., Werner, C. R., Lauer, U. M., Malek, N. P., Berg, C. P. (2015). Epidemiology and Genotyping of Patients with Chronic Hepatitis B: Genotype Shifting Observed in Patients from Central Europe. Polish Journal of Microbiology, 64 (1), 15–21. doi: http://doi.org/10.33073/pjm-2015-002

Han, G. R., Jiang, H. X., Zhao, W., Ge, C. Y., Xu, C. L., Pan, C. (2011). Lamivudine use in the 2nd or 3rd trimester of pregnancy has similar efficacy in preventing vertical transmission of chronic hepatitis B in highly viremic mothers. Hepatology, 54 (S1), 479A.

Pan, C. Q., Mi, L.-J., Bunchorntavakul, C., Karsdon, J., Huang, W. M., Singhvi, G. et. al. (2012). Tenofovir Disoproxil Fumarate for Prevention of Vertical Transmission of Hepatitis B Virus Infection by Highly Viremic Pregnant Women: A Case Series. Digestive Diseases and Sciences, 57 (9), 2423–2429. doi: http://doi.org/10.1007/s10620-012-2187-3

Pan, C. Q., Duan, Z., Bhamidimarri, K. R., Zou, H., Liang, X., Li, J., Tong, M. J. (2012). An Algorithm for Risk Assessment and Intervention of Mother to Child Transmission of Hepatitis B Virus. Clinical Gastroenterology and Hepatology, 10 (5), 452–459. doi: http://doi.org/10.1016/j.cgh.2011.10.041

Schillie, S., Walker, T., Veselsky, S., Crowley, S., Dusek, C., Lazaroff, J. et. al. (2015). Outcomes of Infants Born to Women Infected With Hepatitis B. Pediatrics, 135 (5), e1141–e1147. doi: http://doi.org/10.1542/peds.2014-3213

EASL Clinical Practice Guidelines: Management of chronic hepatitis B virus infection (2012). Journal of Hepatology, 57 (1), 167–185. doi: http://doi.org/10.1016/j.jhep.2012.02.010

Zhang, H., Pan, C. Q., Pang, Q., Tian, R., Yan, M., Liu, X. (2014). Telbivudine or lamivudine use in late pregnancy safely reduces perinatal transmission of hepatitis B virus in real‐life practice. Hepatology, 60 (2), 468–476. doi: http://doi.org/10.1002/hep.27034

Pan, C. Q., Duan, Z., Dai, E., Zhang, S., Han, G., Wang, Y. et. al. (2016). Tenofovir to Prevent Hepatitis B Transmission in Mothers with High Viral Load. New England Journal of Medicine, 374 (24), 2324–2334. doi: http://doi.org/10.1056/nejmoa1508660

Ozaras, R., Inanc Balkan, I., Yemisen, M., Tabak, F. (2015). Epidemiology of HBV subgenotypes D. Clinics and Research in Hepatology and Gastroenterology, 39 (1), 28–37. doi: http://doi.org/10.1016/j.clinre.2014.06.005


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Published
2020-10-29
How to Cite
Mudra, Y. (2020). THE TACTICS OF ANTIVIRAL THERAPY FOR CHRONIC VIRAL HEPATITIS B IN PREGNANT WOMEN. Technology Transfer: Innovative Solutions in Medicine, 14-16. https://doi.org/10.21303/2585-663.2020.001478
Section
Medicine and Dentistry