HEPATITIS B VIRUS AND PREGNANCY – WHAT YOU SHOULD KNOW

Hepatitis B virus (HBV) is a DNA virus that causes acute and chronic viral hepatitis which are leading causes of morbidity and mortality worldwide. Hepatitis B virus is the commonest cause of liver disease in Nigeria.

Hepatitis B virus is hyperendemic in Nigeria and all sub-population groups and all age groups are affected including women and children. The national prevalence of Hepatitis B virus among pregnant women in Nigeria is 6.49%, which is moderately high. This means that there is a significant number of pregnant women in Nigeria who are infected by Hepatitis B virus and they are at risk of developing significant liver damage; they can infect their baby during pregnancy and after delivery; they can infect other members of their families; and they can continue to transmit the virus to other people in the society thereby worsening the burden of the virus in Nigeria.

The Hepatitis B virus can be transmitted from person to person through sharing of sharps, unsafe blood transfusion, having multiple sexual partners, exposure to body secretions of an infected individual and from mother to child during pregnancy and after delivery. Mother-to-child transmission (vertical transmission) is very common in Nigeria. The World Health Organization estimated that about 370,000 newborns are perinatally infected with HBV in sub-saharan Africa annually and about 80–90% of these infected infants develop chronic hepatitis.

Some pregnant women who are infected with the Hepatitis B virus have a higher risk of infecting other people including the baby they are carrying in their womb based on a high viraemia and the presence of a marker of Hepatitis B virus infectivity (HBeAg) in their blood. This category of pregnant women will require antiviral treatment while they are still pregnant and their babies will require both passive and active immunization immediately after birth to prevent mother to child transmission of the Hepatitis B virus.

Mother to child transmission of HBV can be prevented through routine screening of all pregnant women during Booking at the antenatal clinic to identify those who are positive for further evaluation and care. All new born babies must receive the Hepatitis B vaccine Birth Dose (HepB-BD) and complete the routine infant Hepatitis B vaccination series. Babies of Hepatitis B positive mothers must also in addition receive the Hepatitis B Immunoglobulin (HBIG) immediately after birth in order to prevent the transmission of the virus to the newborn.

Public Health interventions that can be deployed to reduce this high burden of Hepatitis B virus infection among pregnant women in Nigeria include widespread public health education and awareness campaign about the Hepatitis B virus especially among the less educated people in the Nigerian society. All unvaccinated adults should receive the complete series of the Hepatitis B vaccine. Other measures include ensuring that there is availability of free routine antenatal HBV screening in all public health institutions so that infected individuals can be identified early, and there should be provision of antiviral prophylaxis for eligible pregnant women at a subsidized cost. Implementation of all these measures would reduce the burden of the Hepatitis B virus among pregnant women in Nigeria as well as among the general population of Nigeria.

ABOUT US

Enlightenment Initiative on Viral Hepatitis (EIVH) is a non-governmental organization made up of a team of dedicated clinicians, gastroenterologists, researchers and scientists who are actively involved in the care and management of patients with viral hepatitis in Nigeria and who are also involved in research activities on viral hepatitis and liver cancer in Nigeria.

Aim: Reduce the transmission of viral hepatitis and its associated morbidity and mortality among Nigerians.

Motto: “Towards a Healthy Liver”

Vision: A nation free from viral hepatitis and its complications.

Mission: To heighten the awareness, prevention, screening and diagnosis of viral hepatitis in Nigeria as well as facilitate access to treatment and prevent complications of viral hepatitis. This is to be achieved through planning and implementation of strategic advocacy, research and interventional programs in the different regions of the country.