Preventing vertical hepatitis B transmission across all borders: a review of current concepts

Daley, Gemma M. (2011) Preventing vertical hepatitis B transmission across all borders: a review of current concepts. Australian Medical Student Journal, 2 (1). pp. 36-40.

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Abstract

Aim: The aim of this review is to emphasise the global significance of Hepatitis B (HBV) and its vertical transmission, and to summarise the current status of preventative strategies.

Methods: A literature review was carried out. PubMed, The Cochrane Collaboration and Medline were searched for both primary studies and reviews pertaining to vertical HBV transmission, its prevention and barriers to prevention. Key words used included "HBV," "Hepatitis B," "vertical transmission," "mother to child transmission," "prevention" and "epidemiology."

Results: HBV is a major cause of death from liver cancer and liver failure. HBV is the ninth leading cause of death internationally and accounts for up to 80% of the world’s primary liver cancers. In highly endemic areas, 75% of chronic HBV is acquired by vertical transmission (mother to child transmission at birth), or by horizontal transmission in early childhood. The earlier in life the disease is acquired, the greater the adverse consequences. Available therapies for preventing mother to child transmission are very effective and include multiple doses of HBV vaccine and usually, HBV immunoglobulin. However, up to 10% of infants acquire HBV despite this standard prophylaxis. Whether anti-viral agents should be given to mothers with a high viral load to prevent transmission remains controversial.

Conclusion: HBV is an extremely important global public health issue. Prevention of vertical transmission is the most important preventative strategy and current prophylactic therapies are highly effective. Emerging approaches for mothers with a high viral load require further investigation to determine whether they are effective and safe. Developing countries face the issues of cost, access and education to apply prevention strategies, while developed countries need processes to ensure adherence to established recommendations.

Item ID: 17384
Item Type: Article (Refereed Research - C1)
ISSN: 1837-1728
Date Deposited: 29 Jun 2011 03:51
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1114 Paediatrics and Reproductive Medicine > 111499 Paediatrics and Reproductive Medicine not elsewhere classified @ 40%
11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110309 Infectious Diseases @ 40%
11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111716 Preventive Medicine @ 20%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920109 Infectious Diseases @ 50%
92 HEALTH > 9205 Specific Population Health (excl. Indigenous Health) > 920501 Child Health @ 50%
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