Published online Sep 27, 2018. doi: 10.4254/wjh.v10.i9.585
Peer-review started: March 29, 2018
First decision: April 18, 2018
Revised: April 26, 2018
Accepted: June 8, 2018
Article in press: June 9, 2018
Published online: September 27, 2018
Hepatitis B virus (HBV) infection is one of the main public health problems across the globe, since almost one third of the world population presents serological markers of contact with the virus. A profound impact on the epidemiology has been exerted by universal vaccination programmes in many countries, nevertheless the infection is still widespread also in its active form. In the areas of high endemicity (prevalence of hepatitis B surface antigen positivity > 7%), mother-to-child transmission represents the main modality of infection spread. That makes the correct management of HBV in pregnancy a matter of utmost importance. Furthermore, the infection in pregnancy needs to be carefully assessed and handled not only with respect to the risk of vertical transmission but also with respect to gravid women health. Each therapeutic or preventive choice deserves to be weighed upon attentively. On many aspects evidence is scarce or controversial. This review will highlight the latest insights into the paramount steps in managing HBV in pregnancy, with particular attention to recommendations from recent guidelines and data from up-do-date research syntheses.
Core tip: Hepatitis B is still a matter of concern worldwide. Particularly challenging is the correct management of infection during pregnancy. Two aspects have to be taken into account: The potential need to treat the mothers and, at once, the necessity to prevent the vertical transmission of the virus to the infants. This review will discuss the most up-to-date evidence on therapeutic and preventive interventions in several scenarios characterizing the course of hepatitis B in pregnancy.