Postpartum hepatitis flares in mothers with chronic hepatitis B infection
Shi OuYang1
Yawen Geng2
Gongqin Qiu1
Yueying Deng2
Haitao Deng1
Calvin Q.Pan3
1.Department of Infectious Diseases,Key Laboratory of Biological Targeting Diagnosis,Therapy,and Rehabilitation of Guangdong Higher Education Institutes,The Fifth Affiliated Hospital of Guangzhou Medical University,Guangzhou,Guangdong,P.R.China2.Department of Infectious Diseases,Key Laboratory of Biological Targeting Diagnosis,Therapy,and Rehabilitation of Guangdong Higher Education Institutes,The Fifth Affiliated Hospital of Guangzhou Medical University,Guangzhou,Guangdong,P.R.China;School of Public Health,North China University of Science and Technology,Tangshan,Hebie,P.R.China3.Department of Infectious Diseases,Key Laboratory of Biological Targeting Diagnosis,Therapy,and Rehabilitation of Guangdong Higher Education Institutes,The Fifth Affiliated Hospital of Guangzhou Medical University,Guangzhou,Guangdong,P.R.China;Division of Gastroenterology and Hepatology,Department of Medicine,NYU Langone Health,New York University Grossman School of Medicine,New York,NY,USA
摘要：Postpartum elevation of alanine aminotransferase(ALT)in mothers with chronic hepatitis B(CHB)presents a significant clinical challenge.However,the existing literature demonstrates inconsistencies regarding its incidence and predictors in mothers infected with the hepatitis B virus(HBV).Recent advancements in antiviral prophylaxis against mother-to-child transmission of HBV and postpartum cessation of antiviral therapy further complicate this issue.Our literature review,spanning PubMed,and two Chinese-language databases(CNKI and Wanfang)from 1 January 2000 to 31 December 2023 aimed to consolidate and analyse available data on the frequency and severity of postpartum ALT flares,identify risk factors,and propose a management algorithm.Data from 23 eli-gible studies involving 8,077 pregnant women revealed an overall incidence of postpartum ALT elevation:25.7%for mild cases,4.4%for moderate cases,and 1.7%for severe cases.In the subgroup of mothers who were HBeAg-positive and on antiviral prophylaxis for preventing mother-to-child transmission,postpartum intermediate and severe ALT elevations were reported with pooled rates of 5.9%and 0.8%,respectively.Importantly,none resulted in mortality or necessitated liver transplantation.Identified risk factors for postpartum ALT flares in mothers with CHB included HBV DNA levels,ALT levels during pregnancy,postpartum cessation of antivi-ral treatment,and HBeAg status.By leveraging this evidence and recent data on predictors of intermediate or severe postpartum ALT flares,we propose a risk-stratified algorithm for managing postpartum ALT elevation and selecting therapy in mothers with CHB,tai-loring different approaches for treatment-naive vs treatment-experienced populations.These recommendations aim to provide guidance for clinical decision-making and enhance patient outcomes.
机标关键词：withchronicflareshepatitisinfectionmotherspostpartum
论文发表日期：2024-12-30
在线出版日期：2026-07-17（本平台首次上网日期，不代表文献的发表时间）
页数：12( 556-567 )
英文信息