1/6/2016 AlgorithmforHBVduringpregnancy

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AlgorithmforhepatitisBvirusduringpregnancy

AntiHBc:hepatitisBcoreantibodyantiHBe:hepatitisBeantibodyantiHBs:hepatitisBsurface
antibodyHBeAg:hepatitisBeantigenHBIG:hepatitisBimmuneglobulinHBsAg:hepatitisB
surfaceantigenHBV:hepatitisBvirus.
*CheckantiHBsandantiHBcifmotherisathighriskforHBVinfection(eg,injectiondruguser,
sexualpartnerorhouseholdcontacthaschronicHBV).MotherswithnoevidenceofpriorHBV
infection(ie,negativeforHBsAg,antiHBs,andantiHBc)shouldbevaccinated.
WomenwhohaveahighHBVDNA(>10 6int.units/mL),elevatedaminotransferaselevels,and/or
apositiveHBeAgshouldbereferredtoahepatologisttoseeifearlyinitiationofantiviralmedications
isneeded.
Startat28to30weeksgestation.Weprefertenofovirratherthanotherantiviralagents.Referto
thetopiconHepatitisBandpregnancyforamoredetaileddiscussionoftreatment.
Forthosewhocontinueantiviraltherapyafterdelivery,theprosandconsofbreastfeedingmust
bediscussedwiththemother.RefertothetopiconHepatitisBandpregnancyformoredetailed
discussionsofbreastfeeding.

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