1. Viral hepatitis and pregnancy
- Author
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Miriam T. Levy, Norah A. Terrault, Ka Wang Cheung, Gonzague Jourdain, Maladies infectieuses et vecteurs : écologie, génétique, évolution et contrôle (MIVEGEC), and Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD [France-Sud])
- Subjects
MESH: Antiviral Agents ,0301 basic medicine ,MESH: Premature Birth ,MESH: Hepatitis, Chronic ,viruses ,Hepatitis C virus ,medicine.disease_cause ,03 medical and health sciences ,Liver disease ,MESH: Perinatal Mortality ,MESH: Pregnancy ,0302 clinical medicine ,medicine ,MESH: Infant Mortality ,MESH: Pregnancy Complications, Infectious ,MESH: Hepatitis, Viral, Human ,MESH: Diabetes, Gestational ,MESH: Hepatitis C ,Hepatitis ,Hepatitis B virus ,MESH: Hepatitis D ,MESH: Humans ,MESH: Hepatitis A ,MESH: Hepatitis B ,Hepatology ,MESH: Viral Hepatitis Vaccines ,business.industry ,MESH: Infant, Newborn ,MESH: Hepatitis E ,Gastroenterology ,Hepatitis A ,MESH: Pregnancy Outcome ,medicine.disease ,MESH: Infant ,3. Good health ,MESH: Infectious Disease Transmission, Vertical ,030104 developmental biology ,Immunology ,MESH: Acute Disease ,030211 gastroenterology & hepatology ,MESH: Maternal Mortality ,Hepatitis D virus ,MESH: Liver Cirrhosis ,MESH: Viral Load ,Viral hepatitis ,business ,MESH: Female ,Viral load ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology - Abstract
The management of viral hepatitis in the setting of pregnancy requires special consideration. There are five liver-specific viruses (hepatitis A, B, C, D, E), each with unique epidemiology, tendency to chronicity, risk of liver complications and response to antiviral therapies. In the setting of pregnancy, the liver health of the mother, the influence of pregnancy on the clinical course of the viral infection and the effect of the virus or liver disease on the developing infant must be considered. Although all hepatitis viruses can harm the mother and the child, the greatest risk to maternal health and subsequently the fetus is seen with acute hepatitis A virus or hepatitis E virus infection during pregnancy. By contrast, the primary risks for hepatitis B virus (HBV), hepatitis C virus (HCV) and hepatitis D virus are related to the severity of the underlying liver disease in the mother and the risk of mother-to-child transmission (MTCT) for HBV and HCV. The prevention of MTCT is key to reducing the global burden of chronic viral hepatitis, and prevention strategies must take into consideration local health-care and socioeconomic challenges. This Review presents the epidemiology of acute and chronic viral hepatitis infection in pregnancy, the effect of pregnancy on the course of viral infection and, conversely, the influence of the viral infection on maternal and infant outcomes, including MTCT. The management of viral hepatitis in the setting of pregnancy requires special consideration. This Review examines each hepatitis virus individually to address the effect of pregnancy on the natural history of infection and how the viral infections influence maternal and infant outcomes, including mother-to-child transmission.
- Published
- 2020