Enhancing interventions for prevention of mother-to-child- transmission of hepatitis B virus

Philippa C Matthews^{1

2

3}, Ponsiano Ocama⁴, Su Wang^{5

6}, Manal El-Sayed⁷, Anna Turkova⁸, Deborah Ford⁸, Judith Torimiro^{9

10}, Ana Cristina Garcia Ferreira¹¹, Angélica Espinosa Miranda¹¹, Fernando Pio De La Hoz Restrepo¹², Emmanuel Seremba⁴, Robinson Mbu¹⁰, Calvin Q Pan¹³, Homie Razavi¹⁴, Geoffrey Dusheiko¹⁵, C Wendy Spearman¹⁶, Saeed Hamid¹⁷

Affiliations

¹ The Francis Crick Institute, 1 Midland Road, London, NW1 1AT, UK.
² Division of Infection and Immunity, University College London, Gower St, London WC1E 6BT, UK.
³ Department of Infection, University College London Hospitals, 235 Euston Rd, London NW1 2BU, UK.
⁴ Department of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.
⁵ Cooperman Barnabas Medical Center, Florham Park, NJ, USA.
⁶ Hepatitis B Foundation, Doylestown, PA, USA.
⁷ Department of Paediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
⁸ Medical Research Council Clinical Trials Unit, University College London, 90 High Holborn, London WC1V 6LJ, UK.
⁹ Chantal Biya International Reference Centre for Research on Prevention and Management of HIV/AIDS (CIRCB), Yaounde, Cameroon.
¹⁰ Faculty of Medicine and Biomedical Sciences, University of Yaounde, Yaounde, Cameroon.
¹¹ Ministry of Health, Health Surveillance Department, Department of Chronic Diseases and Sexually Transmitted Infections, SRTVN Quadra 701, Lote D, PO700 Building, CEP: 70719-040, Brasília/DF, Brazil.
¹² Universidad Nacional de Colombia, Bogotá, Colombia.
¹³ Division of Gastroenterology and Hepatology, NYU Langone Health, NYU Grossman School of Medicine, NY, USA.
¹⁴ Center for Disease Analysis Foundation, 1120 W South Boulder Rd Suite 102, Lafayette, CO 80026, USA.
¹⁵ Liver Unit, King's College Hospital, Denmark Hill, London SE5 9RS, UK.
¹⁶ Division of Hepatology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa.
¹⁷ Department of Medicine, Aga Khan University, Karachi, Pakistan.

PMID: 37554925
PMCID: PMC10405098
DOI: 10.1016/j.jhepr.2023.100777

Review

Enhancing interventions for prevention of mother-to-child- transmission of hepatitis B virus

Philippa C Matthews et al. JHEP Rep. 2023.

. 2023 Apr 24;5(8):100777.

doi: 10.1016/j.jhepr.2023.100777. eCollection 2023 Aug.

Authors

Affiliations

¹ The Francis Crick Institute, 1 Midland Road, London, NW1 1AT, UK.
² Division of Infection and Immunity, University College London, Gower St, London WC1E 6BT, UK.
³ Department of Infection, University College London Hospitals, 235 Euston Rd, London NW1 2BU, UK.
⁴ Department of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.
⁵ Cooperman Barnabas Medical Center, Florham Park, NJ, USA.
⁶ Hepatitis B Foundation, Doylestown, PA, USA.
⁷ Department of Paediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
⁸ Medical Research Council Clinical Trials Unit, University College London, 90 High Holborn, London WC1V 6LJ, UK.
⁹ Chantal Biya International Reference Centre for Research on Prevention and Management of HIV/AIDS (CIRCB), Yaounde, Cameroon.
¹⁰ Faculty of Medicine and Biomedical Sciences, University of Yaounde, Yaounde, Cameroon.
¹¹ Ministry of Health, Health Surveillance Department, Department of Chronic Diseases and Sexually Transmitted Infections, SRTVN Quadra 701, Lote D, PO700 Building, CEP: 70719-040, Brasília/DF, Brazil.
¹² Universidad Nacional de Colombia, Bogotá, Colombia.
¹³ Division of Gastroenterology and Hepatology, NYU Langone Health, NYU Grossman School of Medicine, NY, USA.
¹⁴ Center for Disease Analysis Foundation, 1120 W South Boulder Rd Suite 102, Lafayette, CO 80026, USA.
¹⁵ Liver Unit, King's College Hospital, Denmark Hill, London SE5 9RS, UK.
¹⁶ Division of Hepatology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa.
¹⁷ Department of Medicine, Aga Khan University, Karachi, Pakistan.

PMID: 37554925
PMCID: PMC10405098
DOI: 10.1016/j.jhepr.2023.100777

Abstract

Prevention of mother-to-child transmission of hepatitis B virus (HBV) infection is a cornerstone of efforts to support progress towards elimination of viral hepatitis. Current guidelines recommend maternal screening, antiviral therapy during the third trimester of high-risk pregnancies, universal and timely HBV birth dose vaccination, and post-exposure prophylaxis with hepatitis B immunoglobulin for selected neonates. However, serological and molecular diagnostic testing, treatment and HBV vaccination are not consistently deployed, particularly in many high endemicity settings, and models predict that global targets for reduction in paediatric incidence will not be met by 2030. In this article, we briefly summarise the evidence for current practice and use this as a basis to discuss areas in which prevention of mother-to-child transmission can potentially be enhanced. By reducing health inequities, enhancing pragmatic use of resources, filling data gaps, developing advocacy and education, and seeking consistent investment from multilateral agencies, significant advances can be made to further reduce vertical transmission events, with wide health, societal and economic benefits.

Keywords: HBIG; HBV; PMTCT; birth dose; elimination; hepatitis B virus; prevention; tenofovir; transmission; vaccination; vertical transmission.

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Conflict of interest statement

CWS has received speaker fees from GILEAD Sciences and Abbott. CP received research funding and is a speaker for Gilead. PCM supervises a doctoral student with funding support from GSK. SH has received funding from Gilead for HCV Micro-elimination programs. HR has received research funding and speaker’s honoraria from Gilead Sciences, AbbVie and Pfizer and is a board member of the CDA foundation. SW has received research funding from Gilead Sciences, and honoraria from Prime Inc, and is on the Board of Directors for the Hepatitis B Foundation, World Hepatitis Alliance, and serves in the patient advisory group and HBV special interest group for the AASLD. FR has received consulting fees from Sanofi Pasteur. GD has received consulting fees and speaker fees from Gilead Sciences, has participated on Data Safety Monitoring Board/Advisory Board for janssen, Glaxo Smith Kline, Arbutus, Aligos, Vir and has roles in the National Medical Research Council Singapore and the World Health Organisation Pediatric Working Group on Viral Hepatitis. Please refer to the accompanying ICMJE disclosure forms for further details.

Figures

**Fig. 1**
Areas for enhanced intervention in PMTCT of HBV infection. Graphic shows timeline before, during and after pregnancy, with existing interventions listed at the top, and areas where innovation is needed shown below. Triple elimination – combined interventions for prevention of HBV, HIV and syphilis. HBIG, hepatitis B immunoglobulin; HBV, hepatitis B virus; HepB-BD, hepatitis B birth dose immunisation; PMTCT, prevention of mother-to-child transmission; T1/2/3 - trimester 1/2/3 of pregnancy; TAF, tenofovir alafenamide.

See this image and copyright information in PMC

References

1. World Health Organization . 2016. Towards Ending Viral Hepat. Global health sector strategy on viral hepatitis 2016–2021.https://apps.who.int/iris/handle/10665/246177 WHO/HIV/2016.06.
1. WHO . June 2022. Global health sector strategies on, respectively, HIV, viral hepatitis and sexually transmitted infections for the period 2022-2030.Https://cdn.who.int/media/docs/default-Source/hq-Hiv-Hepatitis-and-Stis-... Published on-line. [n.d]
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Enhancing interventions for prevention of mother-to-child- transmission of hepatitis B virus

Affiliations

Enhancing interventions for prevention of mother-to-child- transmission of hepatitis B virus

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

Grants and funding

LinkOut - more resources

Full Text Sources

Miscellaneous