Guidelines for the management of chronic hepatitis B pregnancy-related conditions

I. Methods of mother-to-child vaccine interruption in our 2010 guidelines: The interruption rate of mother-to-child transmission interrupted by hepatitis B vaccine alone is 87.8% (II-3). Newborns of HBsAg-positive mothers should be injected with hepatitis B immunoglobulin (HBIG) as early as possible within 24 h after birth (preferably 12 h after birth) at a dose of ≥100 IU, and at the same time, they should be vaccinated with 10 μg of recombinant yeast or 20 μg of Chinese hamster oocyte (CHO) hepatitis B vaccine at different sites, and the second and third hepatitis B vaccine should be administered at 1 month and 6 months, respectively, which can significantly improve the interruption of mother-to-child transmission. Hepatitis B vaccination at 1 month and 6 months of age with the second and third doses of hepatitis B vaccine, respectively, significantly improves the efficacy of interruption of mother-to-child transmission (II-3). Alternatively, one dose of HBIG can be given within 12 h of birth, followed by a second dose of HBIG one month later, and one dose of 10 μg of recombinant yeast or 20 μg of CHO Hepatitis B Vaccine at different sites at the same time, followed by the second and third doses of Hepatitis B Vaccine at one and six months intervals, respectively. Newborns can receive breastfeeding from HBsAg-positive mothers after receiving HBIG and hepatitis B vaccine within 12 hours of birth. The 2010 edition of China’s chronic hepatitis B prevention and treatment guideline on antiviral recommendations: pregnancy-related situations: women of reproductive age with chronic hepatitis B can be treated with IFN or nucleoside analogs if there are indications for treatment, and reliable measures should be taken for contraception during the treatment period (Ⅰ). For patients who become pregnant during oral antiviral therapy, if lamivudine or other pregnancy class B drugs (tebivudine or tenofovir) are used, treatment can be continued with adequate information about the risks, weighing the pros and cons, and with the patient signing an informed consent form. If hepatitis B flares occur in pregnancy, depending on the degree of disease, decide whether to give antiviral treatment or not, with adequate information on the risks, weighing the pros and cons, and the patient signing an informed consent form, treatment can be used for lamivudine, telbivudine or tenofovir.(Ⅲ) III. The latest guideline update of the 2012 guideline of the Asia Pacific region on the recommendation of antiviral treatment: In order to prevent mother-to-child transmission, for HBV DNA>2 × 106 IU/mL pregnant women in late pregnancy can be treated with telbivudine (IIA), and tenofovir can also be one of the options (IIIA). For women of childbearing age, interferon-based therapy is preferred for those who are not yet pregnant (IA), and pregnancy is contraindicated during interferon therapy. Pregnancy requiring treatment can be treated with pregnancy class B oral medication (IIA).