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Current progress in the prevention of mother-to-child transmission of hepatitis B and resulting clinical and programmatic implications

Authors Jourdain G, Ngo-Giang-Huong N, Khamduang W

Received 20 February 2019

Accepted for publication 25 March 2019

Published 26 April 2019 Volume 2019:12 Pages 977—987

DOI https://doi.org/10.2147/IDR.S171695

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Cristina Weinberg

Peer reviewer comments 3

Editor who approved publication: Dr Sahil Khanna


Gonzague Jourdain,1–3 Nicole Ngo-Giang-Huong,1–3 Woottichai Khamduang2

1Unit 174-PHPT, Institut de recherche pour le développement (IRD), Marseille, France; 2Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand; 3Department of Immunology and Infectious Diseases, Harvard TH Chan School of Public Health, Boston, MA, USA

Abstract: There is currently no cure for hepatitis B chronic infections. Because new hepatitis B infections result mainly from perinatal transmission, preventing mother-to-child transmission is essential to reach by 2030 the goal of hepatitis B elimination set by the World Health Organization. The universal administration of hepatitis B vaccine to all infants, regardless of maternal status, starting with the birth dose, is the cornerstone of the strategy for elimination. Additional interventions, such as hepatitis B immune globulin administered to newborns and antiviral prophylaxis administered to hepatitis B infected pregnant women, may contribute to reaching the goal earlier. Hepatitis B immune globulin may remain out for reach of many pregnant women in low- and middle-income countries due to cost and logistic issues, but antivirals are cheap and do not require a cold chain for distribution. However, it has been observed that some viruses harbor mutations associated with escape from vaccine-elicited antibodies following immunization or administration of hepatitis B immune globulin. Also, resistance associated mutations have been described for several drugs used for treatment of hepatitis B infected patients as well as for the prevention of mother-to-child transmission. Whether these mutations have the potential to compromise the prevention of mother-to-child transmission or future treatment of the mother is a question of importance. We propose a review of important recent studies assessing tenofovir disoproxil fumarate for the prevention of mother-to-child transmission, and provides detailed information on the mutations possibly relevant in this setting.

Keywords: hepatitis B, mother-to-child transmission, prevention, antiviral, resistance

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