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World J Hepatol. Sep 27, 2018; 10(9): 585-594
Published online Sep 27, 2018. doi: 10.4254/wjh.v10.i9.585
Current evidence on the management of hepatitis B in pregnancy
Alberto Enrico Maraolo, Ivan Gentile, Antonio Riccardo Buonomo, Biagio Pinchera, Guglielmo Borgia
Alberto Enrico Maraolo, Ivan Gentile, Antonio Riccardo Buonomo, Biagio Pinchera, Guglielmo Borgia, Section of Infectious Diseases, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples 80131, Italy
Author contributions: Buonomo AR and Pinchera B performed the research of relevant articles by screening scientific databases; Maraolo AE wrote the paper; Borgia G and Gentile I carried out a critical revision of the entire manuscript for important intellectual content.
Conflict-of-interest statement: The authors report no conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Alberto Enrico Maraolo, MD, Research Fellow, Section of Infectious Diseases, Department of Clinical Medicine and Surgery, University of Naples Federico II, via Sergio Pansini 5, Naples 80131, Italy. albertomaraolo84@alice.it
Telephone: +39-81-7463178 Fax: +39-81-7463094
Received: March 29, 2018
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
Processing time: 182 Days and 17.4 Hours
Abstract

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.

Keywords: Pregnancy; Hepatitis B immunoglobulin; Hepatitis B; Therapy; Immunoprophylaxis; Antiviral prophylaxis

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.