Hepatitis B virus perinatal transmission among Arab women

Epidemiological patterns of hepatitis B virus (HBV) in highly endemic areas

This paper uses meta-analysis of published data and a deterministic mathematical model of hepatitis B virus (HBV) transmission to describe the patterns of HBV infection in high endemicity areas. We describe the association between the prevalence of carriers and a simple measure of the rate of infection, the age at which half the population have been infected (A50), and assess the contribution of horizontal and perinatal transmission to this association. We found that the two main hyper-endemic areas of sub-Saharan Africa and east Asia have similar prevalences of carriers and values of A50, and that there is a negative nonlinear relationship between A50 and the prevalence of carriers in high endemicity areas (Spearman's Rank, P = 0.0086). We quantified the risk of perinatal transmission and the age-dependent of infection to allow a comparison between the main hyper-endemic areas. East Asia was found to have higher prevalences of HBeAg positive mothers and a greater risk of perinatal transmission from HBeAg positive mothers than sub-Saharan Africa, though the differences were not statistically significant. However, the two areas have similar magnitudes and age-dependent rates of horizontal transmission. Results of a simple compartmental model suggest that similar rates of horizontal transmission are sufficient to generate the similar patterns between A50 and the prevalences of carriers. Interrupting horizontal transmission by mass immunization is expected to have a significant, nonlinear impact on the rate of acquisition of new carriers.

Acute viral hepatitis in pregnancy

OBJECTIVE

To describe the clinical outcome of pregnancy and vertical transmission of acute viral hepatitis in pregnancy.

METHODS

Forty-eight pregnant patients with acute viral hepatitis were evaluated clinically and by abdominal ultrasonography. Serological studies for hepatitis markers were performed using radioimmunoassay. The results were evaluated using Student's t-test and tests of proportion.

RESULT

Thirty-five (72.9%) delivered live birth babies at term, while 13 (27.1%) had fetal complications and/or losses. The percentage of fetal complications and/or losses was higher in patients who had non-A, non-B hepatitis (30.8%) than those who had type B hepatitis (25%). The most common fetal complication was premature delivery (14.9%) followed by stillbirth and abortion (8.3%) for each. The overall percentage of vertical transmission of hepatitis B virus was 2 out of 27 (7.4%).

CONCLUSION

Acute viral hepatitis carries a high risk for both mother and fetus. Routine vaccination of all susceptible women and babies against hepatitis B is recommended in endemic areas.