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The textbook of hepatitis B comprehensive: Part 2

(BQ) Continued part 1, part 2 of the document The textbook of hepatitis B comprehensive has contents: Hepatitis B in pregnancy, hepatitis B and delta virus coinfection and superinfection, antivirals against hepatitis B virus, new strategies in hepatitis B management, and other contents. Invite you to refer. | The textbook of hepatitis B comprehensive: Part 2 Hepatitis B in Pregnancy 157 16 Hepatitis B in Pregnancy Desmond Wai, Kai-Chah Tan INTRODUCTION Chronic hepatitis B is a major cause of morbidity and mortality in many parts of Asia, as prevalence of hepatitis B ranged from 4 to 20% in various parts of Asia. It is not uncommon for physicians to encounter pregnant hepatitis B patients in their clinical practice. Besides, maternal-fetal transmission is considered the major source of transmission of hepatitis B in Asia. Hence, it is important for physicians to be aware of hepatitis B management before, during, and after pregnancy. PREPREGNANCY MANAGEMENT Physicians must be aware that none of the antivirals against hepatitis B are classified as FDA pregnancy category A. In patients with chronic hepatitis B requiring antiviral therapy, injectables such as interferon, pegylated interferon α-2a and - 2b are generally given over a 6–12 months period, while oral antivirals such as nucleoside or nucleotide analogs are often given over prolonged period of up to a few years in duration. Therefore, before treating female hepatitis B patients in the reproductive age group, physicians must discuss the potential benefits of antivirals, the possible need for prolonged administration of antivirals, and the insufficient safety data of antivirals during pregnancy with both the patient and the spouse. In patients having mild liver disease, it may be better to wait till the patient has completed her family before administering oral antivirals. Alternatively, physicians can consider using pegylated interferons as the first line treatment for young female hepatitis B patients as they are given over a defined period of time. In patients with severe liver disease and oral antivirals are being administered, it is prudent to ask patients to consider using contraceptives while they are on antiviral treatment. WHEN A HEPATITIS B INFECTED .