Hepatitis B in pregnancy

Hepatitis B remains a global health issue, despite an effective vaccine. Mother to child transmission (MTCT) of hepatitis B has become increasingly recognized, especially in those patients with high maternal viremia. In a woman of childbearing age, carefully assessing disease status and urgency of treatment is key, along with discussion of family planning, timing and choice of therapy. In a pregnant patient with chronic hepatitis B, treatment in the third trimester may be considered in those with HBV DNA levels >107 copies (2 × 106 IU/ml) and may reduce the perinatal transmission rate, but a thorough discussion of the risks and benefits is essential. Duration of antiviral therapy depends upon the indication for treatment as those individuals treated for active disease from the hepatitis B would need long term therapy, while those treated in the third trimester only to prevent MTCT may have therapy discontinued. © 2013 Springer Science+Business Media New York.