Published online Jul 14, 2021. doi: 10.3748/wjg.v27.i26.4182
Peer-review started: February 5, 2021
First decision: March 14, 2021
Revised: March 29, 2021
Accepted: June 2, 2021
Article in press: June 2, 2021
Published online: July 14, 2021
Hepatitis B virus (HBV) is the leading cause of chronic viral hepatitis. Annually, almost two million children younger than 5 years acquire the infection, mostly through vertical or horizontal transmission in early life. Vertical transmission of HBV is a high efficacy phenomenon ranging, in the absence of any preventive interventions, from 70% to 90% for hepatitis e antigen positive mothers and from 10% to 40% for hepatitis e antigen-negative mothers. Maternal viraemia is a preeminent risk factor for vertical transmission of HBV. Maternal screening is the first step to prevent vertical transmission of HBV. Hepatitis B passive and active immunoprophylaxis at birth together with antiviral treatment of highly viraemic mothers are the key strategies for global elimination of HBV infection. Strategies are needed to promote implementation of birth-dose vaccination and hepatitis B immunoglobulins in low- and middle-income countries where the prevalence of the infection is at the highest.
Core Tip: Hepatitis B is one of the main causes of morbidity and mortality worldwide. Vertical transmission is the main transmission route, especially in areas with high prevalence of the infection. Maternal viraemia is a preeminent risk factor for vertical transmission of hepatitis B virus (HBV). Breastfeeding is recommended, although all the conditions leading to maternal-foetal microtransfusions with HBV-infected maternal blood increase the risk of vertical transmission. Neonatal immunoprophylaxis at birth represent the most important approach to prevent HBV infection. The aim of the present narrative review is to summarise the knowledge on prevention of vertical transmission of HBV infection.