Skip to main content

Advertisement

SpringerLink
Log in

Mother-to-infant transmission of hepatitis B virus: challenges and perspectives

  • Point of View
  • Published:
Hepatology International Aims and scope Submit manuscript

Abstract

Chronic hepatitis B virus (HBV) infection due to perinatal mother-to-infant transmission (MTIT) remains a serious global health problem. Despite passive-active immunoprophylaxis using hepatitis B vaccination with or without hepatitis B immunoglobulin (HBIg), up to 8–10% of newborns still acquire HBV infection. Understanding the mechanisms of MTIT is essential for the interruption of HBV transmission. There are three possible routes of transmission: intrauterine transmission, transmission during delivery (intrapartum) and postnatal transmission through close contact or breast milk (postpartum). Overall, positivity for hepatitis B e antigen (HBeAg) and the high viral load of the mothers are the two most important risk factors related to MTIT of HBV. This article briefly reviews the viral factors related to MTIT of HBV and discusses the issues that warrant further investigation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  1. Chen DS. Fighting against viral hepatitis: lessons from Taiwan. Hepatology 2011;54:381–392

    Article  PubMed  Google Scholar 

  2. World Health Organization. Hepatitis B [updated 2015 Mar]. Available from: http://www.who.int/mediacentre/factsheets/fs204/en/

  3. World Health Organization. Hepatitis B vaccines: WHO position paper. Wkly Epidemiol Rec 2009;84:405–420

    Google Scholar 

  4. Beasley RP. Rocks along the road to the control of HBV and HCC. Ann Epidemiol 2009;19:231–234

    Article  PubMed  Google Scholar 

  5. Cheung KW, Seto MT, Wong SF. Towards complete eradication of hepatitis B infection from perinatal transmission: review of the mechanismsof in utero infection and the use of antiviral treatment during pregnancy. Eur J Obstet Gynecol Reprod Biol 2013;169:17–23

    Article  CAS  PubMed  Google Scholar 

  6. Ma L, Alla NR, Li X, et al. Mother-to-child transmission of HBV: review of current clinical management and prevention strategies. Rev Med Virol 2014;24:396–406

    Article  CAS  PubMed  Google Scholar 

  7. Gentile I, Borgia G. Vertical transmission of hepatitis B virus: challenges and solutions. Int J Womens Health 2014;6:605–611

    PubMed  PubMed Central  Google Scholar 

  8. Yi P, Chen R, Huang Y, et al. Management of mother-to-child transmission of hepatitis B virus: propositions and challenges. J Clin Virol 2016;77:32–39

    Article  PubMed  Google Scholar 

  9. Wen WH, Chang MH, Zhao LL, et al. Mother-to-infant transmission of hepatitis B virus infection: significance of maternal viral load and strategies for intervention. J Hepatol 2013;59:24–30

    Article  PubMed  Google Scholar 

  10. Beasley RP, Trepo C, Stevens CE, et al. The e antigen and vertical transmission of hepatitis B surface antigen. Am J Epidemiol 1977;105:94–98

    Article  CAS  PubMed  Google Scholar 

  11. Liu CJ, Kao JH. Global perspective on the natural history of chronic hepatitis B: role of hepatitis B virus genotypes A to. J Semin Liver Dis 2013;33:97–102

    Article  PubMed  Google Scholar 

  12. Stevens CE, Beasley RP, Tsui J, et al. Vertical transmission of hepatitis B antigen in Taiwan. N Engl J Med 1975;292:771–774

    Article  CAS  PubMed  Google Scholar 

  13. Chen HL, Lin LH, Hu FC, et al. Effects of maternal screening and universal immunization to prevent mother-to-infant transmission of HBV. Gastroenterology 2012;142:773–781

    Article  PubMed  Google Scholar 

  14. Chang MH, Chen CJ, Lai MS, et al. Universal hepatitis B vaccination in Taiwan and the incidence of hepatocellular carcinoma in children. Taiwan Childhood Hepatoma Study Group. N Engl J Med 1997;336:1855–1859

    Article  CAS  PubMed  Google Scholar 

  15. Chen HL, Lee CN, Chang CH, et al. Efficacy of maternal tenofovir disoproxil fumarate in interrupting mother-to-infant transmission of hepatitis B virus. Hepatology 2015;62:375–386

    Article  CAS  PubMed  Google Scholar 

  16. Pan CQ, Duan Z, Dai E, et al. Tenofovir to prevent hepatitis B transmission in mothers with high viral load. N Engl J Med 2016;374:2324–2334

    Article  CAS  PubMed  Google Scholar 

  17. Terrault NA, Bzowej NH, Chang KM, et al. AASLD guidelines for treatment of chronic hepatitis B. Hepatology 2016;63:261–283

    Article  PubMed  Google Scholar 

  18. Sarin SK, Kumar M, Lau GK, et al. Asian-Pacific clinical practice guidelines on the management of hepatitis B: a 2015 update. Hepatol Int 2016;10:1–98

    Article  CAS  PubMed  Google Scholar 

  19. Shi Z, Yang Y, Wang H, et al. Breastfeeding of newborns by mothers carrying hepatitis B virus: a meta-analysis and systematic review. Arch Pediatr Adolesc Med 2011;165:837–846

    Article  PubMed  Google Scholar 

  20. Guo Z, Shi XH, Feng YL, et al. Risk factors of HBV intrauterine transmission among HBsAg-positive pregnant women. J Viral Hepat 2013;20:317–321

    Article  CAS  PubMed  Google Scholar 

  21. Xu DZ, Yan YP, Choi BC, et al. Risk factors and mechanism of transplacental transmission of hepatitis B virus: a case-control study. J Med Virol 2002;67:20–26

    Article  PubMed  Google Scholar 

  22. Sarin SK, Kumar M, Shrivastava S, et al. Influence of chronic HBV infection on pregnancy: a human model of maternofetal virus host interactions. Gastroenterology 2011;141:1522–1525

    Article  PubMed  Google Scholar 

  23. Pande C, Sarin SK, Patra S, et al. Hepatitis B vaccination with or without hepatitis B immunoglobulin at birth to babies born of HBsAg-positive mothers prevents overt HBV transmission but may not prevent occult HBV infection in babies: a randomized controlled trial. J Viral Hepat 2013;20:801–810

    CAS  PubMed  Google Scholar 

  24. Jindal A, Singh A, Sarin SK. Prevention of peripartum hepatitis B transmission. N Engl J Med 2016;375:1496–1497

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Physical Therapy and Assistive Technology, National Yang-Ming University, Taipei, Taiwan

    Yi-Fen Shih

  2. Department of Internal Medicine and Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, 1 Chang-Te St, Taipei, 100, Taiwan

    Chun-Jen Liu

  3. Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan

    Chun-Jen Liu

  4. Hepatitis Research Center, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan

    Chun-Jen Liu

Authors
  1. Yi-Fen Shih
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Chun-Jen Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Chun-Jen Liu.

Ethics declarations

Conflict of interest

There are no potential conflicts of interest to declare.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

No informed consent was needed for this review article. None of the materials and results have been presented or published previously.

Funding

The work was supported by grants from the National Taiwan University Hospital; the Ministry of Science and Technology, and Ministry of Health and Welfare, Executive Yuan, Taiwan; and Liver Diseases Prevention and Treatment Research Foundation, Taiwan.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Shih, YF., Liu, CJ. Mother-to-infant transmission of hepatitis B virus: challenges and perspectives. Hepatol Int 11, 481–484 (2017). https://doi.org/10.1007/s12072-017-9831-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12072-017-9831-0

Keywords

Search

Navigation