Hepatitis Flashcards
Hepatitis B
Testing in all women (vertical transmission rate = 20%; 90% if +ve for HBeAg)
- Part of routine antenatal screening programme at booking
Asymptomatic but may show some signs of liver dysfunction (jaundice, hepatomegaly)
Ix: Bloods (esp LFTs), Hep B serology, PCR (viral load)
Antenatal care
- Offer tenofovir disoproxil to women with HBV DNA > 107 IU/mL in the 3rd trimester (to reduce the risk of transmission to the foetus)
- STOP 4-12 weeks after birth unless mother meets criteria for long-term treatment
Babies born to chronically infected mothers or mothers with acute hepatitis B during pregnancy should receive:
- Vaccination (given at birth, 1 month, 6 months serological test for HBV at 12 months)
- HBV IVIG (0.5mL within 12 hours of birth)
C-section does not reduce vertical transmission (however, it’s indicated in cases of HIV + hepatitis B coinfection)
Hepatitis B is NOT transmitted via breastfeeding (and can continue on antiviral treatment)
Hepatitis C
Vertical transmission can occur due to contact with infected maternal blood at time of delivery but UNCOMMON
Not routinely screened for unless HepB positive
RFs - IVDU, Blood transfusions, Tattoos, Body Piercings
Most are asymptomatic
Ix: Bloods (LFTs esp), Detect anti-HCV antibodies, Confirm with PCR for the virus
Treatment contraindicated in pregnancy (ribavirin + interferon)
- Deferred to the post-partum period
- No specific precautions are recommended: there is LOW risk of vertical or blood transmission from mother to foetus
- Elective Caesarean section is NOT recommended unless co-infected with HIV
Hepatitis E
in pregnancy – i.e. pregnant mothers stay away from pork and shellfish
Causes a severe reaction if contracted in the third trimester – sometimes a fulminant hepatitis
