Talk:Abnormal Development - Hepatitis Virus: Difference between revisions
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==2014== | |||
===Antiviral treatment among pregnant women with chronic hepatitis B=== | |||
Infect Dis Obstet Gynecol. 2014;2014:546165. doi: 10.1155/2014/546165. Epub 2014 Dec 7. | |||
Fan L1, Owusu-Edusei K Jr1, Schillie SF1, Murphy TV1. | |||
Abstract | |||
OBJECTIVE: | |||
To describe the antiviral treatment patterns for chronic hepatitis B (CHB) among pregnant and nonpregnant women. | |||
METHODS: | |||
Using 2011 MarketScan claims, we calculated the rates of antiviral treatment among women (aged 10-50 years) with CHB. We described the pattern of antiviral treatment during pregnancy and ≥1 month after delivery. | |||
RESULTS: | |||
We identified 6274 women with CHB during 2011. Among these, 64 of 507 (12.6%) pregnant women and 1151 of 5767 (20.0%) nonpregnant women received antiviral treatment (P < 0.01). Pregnant women were most commonly prescribed tenofovir (73.4%) and lamivudine (21.9%); nonpregnant women were most commonly prescribed tenofovir (50.2%) and entecavir (41.3%) (P < 0.01). Among 48 treated pregnant women with an identifiable delivery date, 16 (33.3%) were prescribed an antiviral before pregnancy and continued treatment for at least one month after delivery; 14 (29.2%) started treatment during the third trimester and continued at least one month after delivery. | |||
CONCLUSION: | |||
Among this insured population, pregnant women with CHB received an antiviral significantly less often than nonpregnant women. The most common antiviral prescribed for pregnant women was tenofovir. These data provide a baseline for assessing changes in treatment patterns with anticipated increased use of antivirals to prevent breakthrough perinatal hepatitis B virus infection. | |||
PMID 25548510 | |||
==2012== | ==2012== | ||
Revision as of 14:57, 15 May 2015
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Cite this page: Hill, M.A. (2024, May 1) Embryology Abnormal Development - Hepatitis Virus. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/Talk:Abnormal_Development_-_Hepatitis_Virus |
2014
Antiviral treatment among pregnant women with chronic hepatitis B
Infect Dis Obstet Gynecol. 2014;2014:546165. doi: 10.1155/2014/546165. Epub 2014 Dec 7.
Fan L1, Owusu-Edusei K Jr1, Schillie SF1, Murphy TV1.
Abstract OBJECTIVE: To describe the antiviral treatment patterns for chronic hepatitis B (CHB) among pregnant and nonpregnant women.
METHODS: Using 2011 MarketScan claims, we calculated the rates of antiviral treatment among women (aged 10-50 years) with CHB. We described the pattern of antiviral treatment during pregnancy and ≥1 month after delivery.
RESULTS: We identified 6274 women with CHB during 2011. Among these, 64 of 507 (12.6%) pregnant women and 1151 of 5767 (20.0%) nonpregnant women received antiviral treatment (P < 0.01). Pregnant women were most commonly prescribed tenofovir (73.4%) and lamivudine (21.9%); nonpregnant women were most commonly prescribed tenofovir (50.2%) and entecavir (41.3%) (P < 0.01). Among 48 treated pregnant women with an identifiable delivery date, 16 (33.3%) were prescribed an antiviral before pregnancy and continued treatment for at least one month after delivery; 14 (29.2%) started treatment during the third trimester and continued at least one month after delivery.
CONCLUSION: Among this insured population, pregnant women with CHB received an antiviral significantly less often than nonpregnant women. The most common antiviral prescribed for pregnant women was tenofovir. These data provide a baseline for assessing changes in treatment patterns with anticipated increased use of antivirals to prevent breakthrough perinatal hepatitis B virus infection.
PMID 25548510
2012
Hepatitis B virus infection and pregnancy: a practical approach
Indian J Gastroenterol. 2012 Apr 21. [Epub ahead of print]
Kumar A. Source Department of Gastroenterology and Hepatology, Sir Ganga Ram Hospital, New Delhi, 110 060, India, ashishk10@yahoo.com.
Abstract
Hepatitis B virus (HBV) infection is a global problem and the world has 350 million carriers of chronic hepatitis B. Over 50 % of these have acquired their infection vertically from their mothers (mother-to-child transmission [MTCT]). Majority (>90 %) of vertically-acquired infection results into chronic infection, due to induction of an immune-tolerant state. Hence, management of chronic HBV during pregnancy and strategies to prevent MTCT would go a long way in global control of HBV infection and the morbidity and mortality associated with it. However, chronic HBV infection in pregnancy presents a unique challenge, because of existence of a complex relationship between the physiological changes of pregnancy and the pathophysiological response of body to HBV. This relationship may lead to a varied presentation of the patient to the doctor depending on the period of her pregnancy and stage of her liver disease. Each of these modes of presentation raises issues that need to be addressed for successful maternal and fetal outcome, including prevention of MTCT of HBV. This review will try to give a practical approach in addressing these issues.
PMID 22528342
Altered microRNA expression profile in maternal and fetal liver of HBV transgenic mouse model
J Matern Fetal Neonatal Med. 2012 Apr 21. [Epub ahead of print]
Guo L, Yang X, Duan T. Source Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine , Shanghai, PR-China, Shanghai , China.
Abstract
Objective: MicroRNAs (miRNAs) regulate gene expression in a post-transcriptional sequence-specific manner. Expression profile analysis of miRNAs in liver is necessary to understand the possible roles of miRNAs in hepatitis B virus (HBV) infection. Methods: We obtained HBV-positive liver samples from mice, using HBV transgenic mouse model. MicroRNA expression was analyzed with Agilent microRNA Array and validated using quantitative real-time PCR analysis. Results: RNA samples from liver of HBV transgenic mouse liver exhibited notably different miR profiles from negative controls for both maternities and fetuses. Significant differences in expression profile of miRNAs were also found in fetal and maternal group of HBV transgenic mouse model. Expression of miR-1892 and miR-1187 decreased by approximately 2-fold (p < 0.01), whereas expression of miR-92a increased by more than 6-fold (p < 0.001) in the fetal group, as validated by qPCR. Conclusion: Deregulation of miRNAs expression in fetal livers could be implicated in HBV intrauterine infection. Further study is warranted to identify the target genes of these miRNAs and their function. Besides, these data might offer new ideas for blocking HBV intrauterine infection.
PMID 22462411
Chronic hepatitis B infection and pregnancy
Obstet Gynecol Surv. 2012 Jan;67(1):37-44.
Giles ML, Visvanathan K, Lewin SR, Sasadeusz J. Source Department of Infectious Diseases, Monash Medical Centre, and Infectious Disease Unit, The Alfred Hospital, Melbourne, Australia. m.giles@alfred.org.au
Abstract
It is estimated that 350 to 400 million individuals worldwide are chronically infected with hepatitis B virus (HBV). In regions of high endemicity, many of these are females of reproductive age who are an important source for perinatal transmission. There are a number of issues specific to the women of childbearing age who have chronic HBV infection, including the safety of antiviral therapy during pregnancy and breast-feeding, the changes in the immune system during pregnancy and postpartum that may impact on the natural history of HBV, and the emerging role of antivirals to reduce perinatal transmission of HBV. For women in their reproductive years who require treatment, many of the available antivirals have not been studied in pregnant or breast-feeding women and their use requires the development of a carefully considered strategy, considering the impact of both the disease and treatment on the mother and fetus/infant. The purpose of this article is to (1) review data regarding the mechanisms and timing of perinatal HBV infection; (2) review data on interventions, particularly antiviral therapy, to reduce perinatal transmission beyond the protection afforded by hepatitis B immunoglobulin and vaccination; (3) summarize the immunological changes associated with pregnancy and the potential effect these may have on the natural history of HBV infection; and (4) summarize the information currently available for antiviral therapy available for HBV treatment, focusing specifically on safety data pertaining to reproduction, pregnancy, and breast-feeding.
TARGET AUDIENCE: Obstetricians & Gynecologists and Family Physicians.
LEARNING OBJECTIVES: After completing this CME activity physicians should be better able to classify the interventions to reduce mother-to-child transmission of hepatitis B including antivirals, caesarean section, hepatitis B immunoglobulin and hepatitis B vaccine, assess the immunological changes associated with pregnancy and the potential effect this may have on the natural history of HBV infection and apply the information currently available for antiviral therapy licensed for HBV treatment, focusing specifically on safety data in pregnancy and during breastfeeding.
PMID 22278077
