Some young men and women with “major triple-positive” fear that they will “inherit” the hepatitis B virus to their children and want to have children after they are cured. The company’s main goal is to provide the best possible service to its customers. In fact, “big three positive” young men and women of childbearing age as long as they do a good job of preventive measures, the same can be married and have children. Think about it: there are tens of millions of young men and women of childbearing age in China, if they do not get married and give birth, will not affect the “ecological balance” of our population structure?
Young people: don’t delay your youth, come out of the misunderstanding. It is not the hepatitis B virus that is driving the unhappy men and women, but the misconceptions about the hepatitis B virus. The young men and women with “major three positives” are not only able to get married and have children, but young mothers are also able to breastfeed safely. This is a vocation in life that you should be brave enough to take on.
How can a mother with hepatitis B virus transmit it to her newborn baby?
Transmission from a mother with the hepatitis B virus to her child can occur through different transmission mechanisms.
1. Intrauterine transmission
Hepatitis B virus is present in semen and vaginal secretions and can be transmitted through sexual intercourse, which is also a sexually transmitted disease; however, human sperm and eggs do not contain hepatitis B virus and cannot be transmitted through genetic transmission.
The fertilized egg develops into an embryo and then into a fetus in the uterus, and the uterine surface of the mother passes nutrients through the microvascular wall into the placental microvasculature of the fetus. 2 layers of microvasculature allow the dissolved nutrients to pass through, but block the virus particles from passing through, so mother-to-child transmission of hepatitis B virus rarely occurs in the uterus. However, if a pregnant woman falls, jumps or bumps violently, the placenta is slightly detached and the leaking maternal blood enters the fetal blood circulation, mother-to-child transmission in utero can occur.
Most of the viruses infecting infants at birth are hidden in lymphocytes, and the detection rate of hepatitis B virus (HBV DNA) in blood is not high, but some of these pediatric patients may have occult hepatitis B virus infection if no surface antibodies (anti-HBs) appear after completing immunization with hepatitis B vaccine.
2. Perinatal transmission
Newborns have a large amount of maternal blood contamination during delivery, which is the most important way for infants to become infected with hepatitis B virus. The high risk of infection in newborns depends on the level of infection in the mother.
If no effective measures are taken, more than 70% of infants of mothers with “major triple-positive” disease will be infected; mothers with HBV DNA >1.0×108 copies/mL are the most infectious, and more than 90% of infants will be infected. More than 90% of infants will be infected. 80% of infected infants will become chronic carriers. Only about 10% of infants of mothers with “minor triple-positive” disease are infected, and because of the small amount of virus, they are quickly cleared up and generally do not become chronic carriers.
How to interrupt mother-to-child transmission?
1. Prevent in utero transmission
Pregnant women should certainly be active and should do some smooth exercises; but don’t jump, don’t fall, and don’t sit in the back seat of the bus, which may reduce some intrauterine transmission.
2. Prevention of perinatal transmission.
Hepatitis B vaccination and hepatitis B immunoglobulin injection, the mother’s infection level is different, the hepatitis B vaccination program should also be different.
For newborns of mothers with “minor triplets”, the first dose of hepatitis B vaccine (10 μg) alone must be given within 24 hours of birth, and 10 μg each at intervals of 1 and 6 months. 90% or more protection can be obtained and the child will not develop chronic viral carriage.
Newborns of mothers with “major triple-positive” disease: mothers with “major triple-positive” disease have higher serum viral levels, so a combination of hepatitis B vaccine and hepatitis B immunoglobulin is necessary to prevent mother-to-child transmission.
Hepatitis B vaccine: 20 μg is required each time, and the routine injection schedule is once within 24 hours, once at 1 month and once at 6 months; it is best to add an additional injection in the second month. Why is this necessary? The mother’s virus is contaminating the newborn during delivery, and the incubation period for establishing infection takes about 2 months. Infants need repeated injections of the vaccine for their bodies to gradually produce sufficient antibodies, so the earlier the injections are started, the better; an additional injection at 2 months has a booster effect.
Hepatitis B immunoglobulin: It takes 2 to 3 months for infants who have received the hepatitis B vaccine to develop a small amount of antibodies, so for early protection, hepatitis B immunoglobulin must also be injected within 24 hours of birth. Antibodies can appear in the serum after the injection is absorbed, and there is protection. The dose of hepatitis B immunoglobulin needs to be 200 units and must be injected on a different side of the hip from the vaccine so that the vaccine (antigen) will not be neutralized locally with the globulin (antibody).
The combination of hepatitis B vaccine and hepatitis B immune globulin provides more than 90% protection for newborns of mothers with “major triplets”.
Mothers with “major triplet” should have their serum HBV DNA levels checked at 32 weeks of pregnancy. If the mother’s child is still at risk of infection with >107 copies/mL, she should consult a specialist for a solution.