Exploring the impact of hepatitis B immunoglobulin and antiviral interventions to reduce vertical transmission of hepatitis B virus

Table 1 The mechanism of hepatitis B immune and antiviral prophylaxis to reduce mother-to-child transmission

MTCT Intervention	Mechanism	Ref.
Immunoprophylaxis
Hepatitis B immunoglobulin	Blocks viral attachment and subsequent entry of HBV into hepatocytes; neutralizes circulating HBV and target infected cells via antibody-mediated immune response; has to be administered within 24 hours of birth	[56,57]
Hepatitis B vaccine	Induces active immunity by producing antibodies that target the surface antigen of HBV; given in three doses, at 0, 1, and 6 months, with the first dose recommended within 24 hours after birth	[58]
Antiviral prophylaxis
Lamivudine, Telbivudine	Deoxycytidine nucleoside analogues; acts as obligate DNA chain terminators; have low genetic barrier to resistance that can lead to drug resistance; not recommended as first-line antiviral therapy for pregnant women	[59,60]
Entecavir	Deoxyguanosine nucleoside analogue; inhibits replication of HBV by inhibiting HBV polymerase; halts HBV DNA elongation after incorporating a few additional bases; has high genetic barrier to drug resistance	[61]
Tenofovir disoproxil fumarate, Tenofovir alafenamide fumarate	Nucleos(t)ide analogues; inhibits viral replication by inhibiting HBV polymerase; have a high genetic barrier to drug resistance; tenofovir disoproxil fumarate is the current recommended antiviral therapy for pregnant women to prevent MTCT	[62]

MTCT: Mother-to-child transmission; HBV: Hepatitis B virus.