Hepatitis B Virus Infection in Pregnancy: Immunological Response, Natural Course and Pregnancy Outcomes
This review aimed to provide an update on the impact of pregnancy on the natural course of hepatitis B virus (HBV) infection and also on the impact of HBV infection on adverse pregnancy outcomes, including mother-to-child transmission (MTCT). For the literature review, original research articles, re...
| Main Authors: | , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2021-06-01
|
| Series: | Journal of Clinical Medicine |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2077-0383/10/13/2926 |
| _version_ | 1797528321367474176 |
|---|---|
| author | Sirinart Sirilert Theera Tongsong |
| author_facet | Sirinart Sirilert Theera Tongsong |
| author_sort | Sirinart Sirilert |
| collection | DOAJ |
| description | This review aimed to provide an update on the impact of pregnancy on the natural course of hepatitis B virus (HBV) infection and also on the impact of HBV infection on adverse pregnancy outcomes, including mother-to-child transmission (MTCT). For the literature review, original research articles, review articles, and guidelines were narratively reviewed and comprehensively validated. The databases of PubMed, EMBASE, and CINAHL were carefully searched for articles in English on topics related to HBV infection, pregnancy, and vertical transmission from 1960 to May 2021. Immunological changes during pregnancy such as suppression of Th1 response and induction of Th2 immunity lead to an impaired immune reaction to HBV and stimulate viral activity along with the reduction of CD8 T cells to escape immune detection. The impact of pregnancy on the natural course of chronic HBV infection seems to be minimal, while pregnancy can increase morbidity and mortality in the case of advanced HBV hepatitis or cirrhosis. Importantly, hepatitis flare or alanine aminotransferase (ALT) flare can occur during pregnancy and is more common during the postpartum period due to the interaction between HBV and the immune response. Interestingly, the impact of HBV infection on adverse pregnancy outcomes is more serious than ever thought. Updated evidence indicates that pregnancies with chronic HBV infection increase the risk of preterm birth and gestational diabetes, especially in cases of positive hepatitis e antigen (HBeAg). |
| first_indexed | 2024-03-10T09:56:36Z |
| format | Article |
| id | doaj.art-3ba4a75d823341029dbbb7640e875c75 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T09:56:36Z |
| publishDate | 2021-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-3ba4a75d823341029dbbb7640e875c752023-11-22T02:18:19ZengMDPI AGJournal of Clinical Medicine2077-03832021-06-011013292610.3390/jcm10132926Hepatitis B Virus Infection in Pregnancy: Immunological Response, Natural Course and Pregnancy OutcomesSirinart Sirilert0Theera Tongsong1Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, ThailandDepartment of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, ThailandThis review aimed to provide an update on the impact of pregnancy on the natural course of hepatitis B virus (HBV) infection and also on the impact of HBV infection on adverse pregnancy outcomes, including mother-to-child transmission (MTCT). For the literature review, original research articles, review articles, and guidelines were narratively reviewed and comprehensively validated. The databases of PubMed, EMBASE, and CINAHL were carefully searched for articles in English on topics related to HBV infection, pregnancy, and vertical transmission from 1960 to May 2021. Immunological changes during pregnancy such as suppression of Th1 response and induction of Th2 immunity lead to an impaired immune reaction to HBV and stimulate viral activity along with the reduction of CD8 T cells to escape immune detection. The impact of pregnancy on the natural course of chronic HBV infection seems to be minimal, while pregnancy can increase morbidity and mortality in the case of advanced HBV hepatitis or cirrhosis. Importantly, hepatitis flare or alanine aminotransferase (ALT) flare can occur during pregnancy and is more common during the postpartum period due to the interaction between HBV and the immune response. Interestingly, the impact of HBV infection on adverse pregnancy outcomes is more serious than ever thought. Updated evidence indicates that pregnancies with chronic HBV infection increase the risk of preterm birth and gestational diabetes, especially in cases of positive hepatitis e antigen (HBeAg).https://www.mdpi.com/2077-0383/10/13/2926hepatitis B virusimmunological responseoutcomespregnancy |
| spellingShingle | Sirinart Sirilert Theera Tongsong Hepatitis B Virus Infection in Pregnancy: Immunological Response, Natural Course and Pregnancy Outcomes Journal of Clinical Medicine hepatitis B virus immunological response outcomes pregnancy |
| title | Hepatitis B Virus Infection in Pregnancy: Immunological Response, Natural Course and Pregnancy Outcomes |
| title_full | Hepatitis B Virus Infection in Pregnancy: Immunological Response, Natural Course and Pregnancy Outcomes |
| title_fullStr | Hepatitis B Virus Infection in Pregnancy: Immunological Response, Natural Course and Pregnancy Outcomes |
| title_full_unstemmed | Hepatitis B Virus Infection in Pregnancy: Immunological Response, Natural Course and Pregnancy Outcomes |
| title_short | Hepatitis B Virus Infection in Pregnancy: Immunological Response, Natural Course and Pregnancy Outcomes |
| title_sort | hepatitis b virus infection in pregnancy immunological response natural course and pregnancy outcomes |
| topic | hepatitis B virus immunological response outcomes pregnancy |
| url | https://www.mdpi.com/2077-0383/10/13/2926 |
| work_keys_str_mv | AT sirinartsirilert hepatitisbvirusinfectioninpregnancyimmunologicalresponsenaturalcourseandpregnancyoutcomes AT theeratongsong hepatitisbvirusinfectioninpregnancyimmunologicalresponsenaturalcourseandpregnancyoutcomes |