TACTICS OF MANAGEMENT AND TREATMENT OF VIRAL HEPATITIS B IN PREGNANT WOMEN
Keywords:
hepatitis B, pregnancy, virus, cirrhosis of the liverAbstract
The etiological role of hepatitis B /HBV/, C/HCV/ and delta/HDV/ viruses has been proven in the development of chronic viral hepatitis. Chronic viral hepatitis, as is known, is characterized by the latency of the course, the predominance of inactive and inactive forms; only a part (up to 1/4) of those infected on average for 20-30 years have the development of cirrhosis of the liver and there is a risk of developing hepatocellular carcinoma. At the same time, combined infection with two (HBV and HDV, HBV and HCV) or three hepatitis viruses accelerates the rate of disease progression. The effect of pregnancy on the course of chronic viral hepatitis has been studied in a number of studies, including a study conducted in our clinic. It has been shown that in most patients pregnancy does not affect the course of the disease and does not pose a risk to the mother.
The course of chronic viral hepatitis in pregnant women is characterized, as a rule, by low activity and the rarity of exacerbations, which are manifested by an increase in laboratory signs of cytolysis and are observed more often in the first half of pregnancy or after its resolution.
This article extensively covers the issues of management, treatment and prevention of viral hepatitis B in pregnant women.
References
Антонова Т.В., Барановская В.Б. Кардиоваскулярные аспекты HBV-инфекции // Журн. инфектологии. — 2009. — Т. 1. — № 2/3. — С. 13 — 24.
Игнатова Т.М., Апросина З.Г., Шехтман М.М., Сухих Г. Т. Вирусные хронические заболевания печени и беременность. // Акуш. игин. - 2013. -№2.С.20-24.
Мухин Н.А., Абдурахманов Д.Т., Лопаткина Т.Н. Внепеченочные проявления хронических заболеваний печени в практике терапевта // Рос.мед. форум. - 2008. -№1. - С. 46-51.;
Сторожок С.А., Панченко Л.Ф., Филиппович Ю.Д., Глушков В.С. Изменения физико-химических свойств биологических мембран при развитии толерантности к этанолу // Вопр. мед.химии. - 2011. -№ 2. - С. 42 - 51.
EASL clinical practice guidelines: Management of chronic hepatitis B virus infection. J Hepatol 2012; 57(1):167-85. 33.
Everson G.T. Liver problems in pregnancy: part 2 - managing pre-existing and pregnancy-induced liver disease. // Medscape WomensHelpth. - 2018. - v.3. p.2;
Keramat A, Younesian M, GholamiFesharaki M, Hasani M, Mirzaei S, Ebrahimi E. Inactive Hepatitis B Carrier and Pregnancy Outcomes: A Systematic Review and Meta-analysis. Iran J Public Health. 2017; 46(4):468-474;
Michelsen P.P., Van Damme P. Viral hepatitis and pregnancy. // ActaGastroenterol.Belg. - 2009. -v.62.-p.21-29.
Pan CQ, Duan ZP, Bhamidimarri KR, Zou HB, Liang XF, et al. An algorithm for risk assessment and intervention of mother to child transmission of hepatitis B virus. ClinGastroenterolHepatol. 2012; 10(5): 452-459
Riely C.A. Liver disease in pregnant patient. // Am.J.Gastroenterol. - 2019. - v.94. - p.1728-1732.
Wirsing von Koning C.H. Hepatitis viruses and pregnancy. // Immune Infect. - 2013. - v.21. -p.16-19; Management of Hepatitis B in pregnancy. RANZCOG 2016; 1-13.