Acute hepatitis B in pregnant women


DOI: https://dx.doi.org/10.18565/epidem.2025.15.4.68-73

Sotnichenko A.S., Zhukova L.I., Kovalevskaya O.I.

1) Specialized Clinical Infectious Diseases Hospital, Ministry of Health of the Krasnodar Krai, Krasnodar, Russia; 2) Kuban State Medical University, Ministry of Health of the Russia, Krasnodar, Russia
Objective. Identification of the clinical features of acute hepatitis B (AHB) in pregnant women.
Materials and methods. A retrospective analysis of the course of AHB was conducted in 46 pregnant women (Group 1) treated at the Specialized Clinical Infectious Diseases Hospital in 2000–2023, as well as in 44 non-pregnant women (Group 2), randomly selected and matched for age.
Results. There were no significant differences in the incidence of icteric and anicteric forms, severe, moderate, mild, complicated, and protracted course of AHB among hospitalized pregnant and non-pregnant women. Iron deficiency anemia and chronic pyelonephritis were significantly more common among the comorbidities in Group 1. The pre-icteric period in pregnant women was shorter, and dyspeptic and asthenovegetative forms were significantly more common. Vomiting was less common during the icteric period in Group 1. The pregnant women had normal mean prothrombin index values. Patients in Group 2 were significantly more often prescribed H2-histamine receptor antagonists and hemostatic agents. Severe AHB was more common in the third trimester of pregnancy, moderate in the second, and mild in the first. Preterm labor in the third trimester associated with AHB was observed in 14.6% of patients.
Conclusion. The characteristics of acute hepatitis B during pregnancy include a shorter pre-icteric period with a predominance of dyspeptic and asthenovegetative forms, less pronounced manifestations of dyspeptic syndrome during the icteric period, and a predominance of severe forms in the third trimester of gestation.

Literature


1. Острый гепатит В (ГВ) у взрослых: клинические рекомендации. Минздрав России, 2024. . https://cr.minzdrav.gov.ru/view-cr/672_2


(Acute hepatitis B (HBV) in adults: сlinical recommendations). Ministry of Health of the Russian Federation, 2024. (In Russ.). https://cr.minzdrav.gov.ru/view-cr/672_2


2. World Health Organization. Global hepatitis report 2024: аction for access in low- and middle-income countries. 2024. https://www.who.int/teams/global-hiv-hepatitis-and-stis programmes/hepatitis/overview


3. Garcia-Romero C.S., Guzman C., Cervantes A., Cerbon M. Liver disease in pregnancy: Medical aspects and their implications for mother and child. Ann. Hepatol. 2019; 18: 553–562. DOI: 10.1016/j.aohep.2019.04.009


4. Jonas M.M. Hepatitis B and pregnancy: An underestimated issue. Liver Int. 2009; 29 (Suppl. 1): 133–139. DOI: 10.1111/j.1478-3231.2008.01933.x


5. Han Y.T., Sun C., Liu C.X., Xie S.S., Xiao D., Liu L. et al. Clinical features and outcome of acute hepatitis B in pregnancy. BMC Infect. Dis. 2014; 14: 368. DOI: 10.1186/1471-2334-14-368


6. Mohite B.J., Rath S., Bal V., Kamat S.A., Marathe S.N., Zuckerman A.J. et al. Mechanisms of liver cell damage in acute hepatitis B. J. Med. Virol. 1987; 14(3): 199–210. DOI: 10.1002/jmv.1890220302


7. Шехтман М.М. Клинико-иммунологические варианты острых вирусных гепатитов и беременность. Гинекология 2004; 6 (1): 39–42.


Shekhtman MM. Clinical and immunological variants of acute viral hepatitis and pregnancy. Gynecology 2004; 6 (1): 39–42 (in Russ.).


8. Xiao B., Liu A., Zhang M., Xue H., Zhue Y. Observation of the effect of the pregnancy complicated with the hepatitis B infection on the lying-in women and neonates. Saudi J. Biol. Sci. 2019; 26(8): 1978–1981. DOI: 10.1016/j.sjbs.2019.08.020


9. Карагулова П.Н., Кадырбеков Б.К. Гепатиты и их влияние на беременность. Известия вузов Кыргызстана 2023; (5): 47–49. DOI: 10.26104/IVK.2023.45.557


Karagulova. P.N., Kadyrbekov B.K. (Hepatitis and its impact on pregnancy). Izvestiya vysshih uchebnyh zavedeniy Kyrgyzstana 2023; (5): 47–49. (In Russ.). DOI: 10.26104/IVK.2023.45.557


10. Afraie M., Moradi G., Zamani K., Azami M. The Effect of Hepatitis B Virus on the Risk of Pregnancy Outcomes: a Systematic Review and Meta-analysis of Cohort Studies. Virol. J. 2023; 20: 213. DOI: 10.1186/s12985-023-02182-0


11. Wu J., Wang H., Xiang Z., Jiang C., Xu Y., Zhai G., Ling Z.; Chinese Consortium for the Study of Hepatitis E (CCSHE). Role of viral hepatitis in pregnancy and its triggering mechanism. J. Transl. Int. Med. 2024; 12(4): 344–354. DOI: 10.2478/jtim-2024-0015


12. Anwar A.D., Nugrahani A.D., Santoso D.P.J., Aziz M.A., Ulfah L., Surachman A. Assessing the Impact of Hepatitis B Elimination Program on Maternal-Infant Health in West Java, Indonesia: A Cross-Sectional Study. Med. Sci. Monit. 2023; 29: e941639. DOI: 10.12659/MSM.941639


13. Yang Y., Cheng W.T., Zhou Y.B. Co-infection and sympathy between HIV and HBV Influences of infection on pregnancy outcomes. J. Epidemiol. Zhongmei. 2017; 38(6): 837–840. DOI: 10.3760/cma.j.issn.0254-6450.2017.06.029


14. Джалалова Н.А., Азимова А.А., Атамухамедова Д.М. Клинико-эпидемиологические и биохимические особенности вирусного гепатита В и С у беременных. Здоровье – основа человеческого потенциала: проблемы и пути их решения. 2021; 16(2): 475–483.


Djalalova N.A., Azimova A.A., Atamukhamedova D.M. (Clinical, epidemiological and biochemical features of viral hepatitis b and c in pregnant women). Health is the basis of human potential: problems and solutions 2021; 16 (2): 475–483. (In Russ.).


15. Sirilert S., Tongsong T., Stasi C. Hepatitis B Virus Infection in Pregnancy: Immunological Response. Natural Course and Pregnancy Outcomes. Clin. Med. 2021; 10(13): 2926. DOI: 10.3390/jcm10132926


16. Рахимова С., Джуманов Б. Острый вирусный гепатит В и беременность. Журнал вестник врача 2016; 1(2): 46–49.


Rakhimova S., Dzhumanov B., (Acute Viral Hepatitis B and Pregnancy). Doktor axborotnomasi 2016; 1(2): 46–49. (In Russ.).


17. Gambarin-Gelwan M. Hepatitis B in pregnancy. Clin. Liver Dis. 2007; l(4): 945–963. DOI: 10.1016/j.cld.2007.08.004


About the Autors


Anastasia S. Sotnichenko, Infectiologist, Department, Medical Care Quality Control Department, Specialized Clinical Infectious Diseases Hospital, Ministry of Health of Krasnodar Krai, Krasnodar, Russia; nastenka18.09@mail.ru; https://orcid.org/0000-0002-7618-3646
Professor Larisa I. Zhukova, МD, Professor, Department of Infectious Diseases and Epidemiology, Kuban State Medical University, Ministry of Health of the Russia; Infectiologist, Specialized Clinical Infectious Diseases Hospital, Ministry of Health of the Krasnodar Krai, Krasnodar, Russia; goukova@mail.ru; https://orcid.org/0000-0002-5306-2956
Olga I. Kovalevskaya, MD, Deputy Chief Physician for Clinical Expertise Work, Specialized Clinical Infectious Diseases Hospital of the Ministry of Health of the Krasnodar Krai, Krasnodar, Russia; olga.kovalevskaya.67@mail.ru; https://orcid.org/0000-0003-3710-7533


Similar Articles


Бионика Медиа