Review
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World J Gastroenterol. Sep 14, 2012; 18(34): 4677-4683
Published online Sep 14, 2012. doi: 10.3748/wjg.v18.i34.4677
Hepatitis B in pregnancy
Guglielmo Borgia, Maria Aurora Carleo, Giovanni Battista Gaeta, Ivan Gentile
Guglielmo Borgia, Maria Aurora Carleo, Ivan Gentile, Department of Public Medicine and Social Security, Section of Infectious Diseases, University of Naples "Federico II", 80131 Naples, Italy
Giovanni Battista Gaeta, Department of Internal Medicine, Section of Infectious Diseases, Second University of Naples, 80131 Naples, Italy
Author contributions: Gentile I and Carleo MA drafted the manuscript; Gaeta GB drafted part of the manuscript and revised the entire manuscript; Borgia G drafted part of the manuscript, revised it and was coordinator of the writing team.
Correspondence to: Guglielmo Borgia, MD, Professor of Infectious Disease, Department of Public Medicine and Social Security, Section of Infectious Diseases, Ed. 18, University of Naples "Federico II", Via Sergio Pansini 5, 80131 Naples, Italy. borgia@unina.it
Telephone: +39-81-7463083 Fax: +39-81-7463190
Received: August 22, 2011
Revised: December 5, 2011
Accepted: March 28, 2012
Published online: September 14, 2012
Abstract

Chronic hepatitis B virus (HBV) infection affects about 350 million individuals worldwide. Management of HBV infection in pregnancy is difficult because of several peculiar and somewhat controversial aspects. The aim of the present review is to provide a tool that may help physicians to correctly manage HBV infection in pregnancy. This review focuses on (1) the effect of pregnancy on HBV infection and of HBV infection on pregnancy; (2) the potential viral transmission from mother to newborn despite at-birth prophylaxis with immunoglobulin and vaccine; (3) possible prevention of mother-to-child transmission through antiviral drugs, the type of antiviral drug to use considering their efficacy and potential teratogenic effect, and the timing of their administration and discontinuation; and (4) the evidence for the use of elective caesarean section vs vaginal delivery and the possibility of breastfeeding.

Keywords: Hepatitis B virus, Pregnancy, Therapy, Tenofovir, Lamivudine, Telbivudine, Entecavir, Breastfeeding, Elective caesarean section