Health care of Kyrgyzstan
Zdravoohraneniye Kyrgyzstana

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Risk factors for vertical transmission of hepatitis B virus and effectiveness of different preventive strategies in pregnant women

https://dx.doi.org/10.51350/zdravkg2025.4.12.9.73.79
Risk factors for vertical transmission of hepatitis B virus and effectiveness of different preventive strategies in pregnant women
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Abstract About the authors References

Abstract

Introduction. Vertical transmission of hepatitis B virus (HBV) remains a major problem in perinatal medicine, as it determines the risk of chronic HBV infection in the child. Study objective. To identify the key risk factors for vertical transmission of HBV and to evaluate the effectiveness of different preventive strategies for neonatal infection. Materials and methods. A retrospective analysis of data from 231 pregnant women with chronic HBV infection was performed. Serological, molecular biological and laboratory parameters, including the APRI index, were assessed. Statistical analysis was carried out using the χ² test and the Mann–Whitney U test. Results and discussion. An increased APRI index in pregnant women with chronic HBV infection (p < 0.0001) was identified as the main risk factor for HBsAg-positive status in newborns, emphasizing the importance of fibrosis assessment for predicting vertical transmission. Combined prophylaxis (vaccination plus HBIG) provided complete protection against infection, whereas with vaccination alone HBsAg was detected in 13.1% of infants (p = 0.009). Vertical transmission was observed at all stages of chronic infection, including HBeAg-negative forms with low viremia (< 200,000 IU/mL). Early initiation of tenofovir (TDF) in combination with vaccination effectively prevented viral transmission and may serve as an alternative to HBIG-containing regimens. Conclusion. The combination of antiviral therapy and specific immunoprophylaxis represents the most effective strategy for reducing the risk of vertical HBV transmission.

About the authors

Турсунбаева Мира Сабирбековна, ассистент кафедры инфекционных болезней Международной высшей школы медицины, Бишкек, Кыргызская Республика

Tursunbaeva Mira Sabirbekovna, Assistant, Department of Infectious Diseases, International Higher School of Medicine, Bishkek, Kyrgyz Republic

Турсунбаева Мира Сабирбековна, Эл аралык жогорку медицина мектебинин жугуштуу оорулар кафедрасынын ассистенти, Бишкек, Кыргыз Республикасы

References

1. World Health Organization. Prevention of mother-to-child transmission of hepatitis B virus: guidelines on antiviral prophylaxis
in pregnancy. Geneva: WHO; 2020. https://www.who.int/publications/i/item/978-92-4-000270-8
2. Tran TT, Ahn J, Reau NS. Treatment and prevention of viral hepatitis in pregnancy. Clin Liver Dis. 2021;25(2):237–254.
https://pmc.ncbi.nlm.nih.gov/articles/PMC8907340
3. European Association for the Study of the Liver (EASL). EASL Clinical Practice Guidelines: Management of chronic hepatitis
B virus infection. J Hepatol. 2023;79(1):S1–S33. https://www.journal-of-hepatology.eu/article/S0168-8278(23)00181-2/fulltext
4. Zhang J, et al. A scoping review of hepatitis B guidelines to reduce mother-to-child transmission. Lancet Reg Health West Pac.
2025;43:100772. https://pmc.ncbi.nlm.nih.gov/articles/PMC11772972
5. World Health Organization. Hepatitis B vaccines: WHO position paper. Wkly Epidemiol Rec. 2017;92(27):369–392.
https://www.who.int/publications/i/item/WER9227
6. Zhou YH, Hu Y, Liu X, Yang H; CSOG MFM Committee. CSOG MFM Committee Guideline: Management of Hepatitis B
During Pregnancy and Prevention of Mother-to-Child Transmission of Hepatitis B Virus (2020). Maternal Fetal Med. 2021;3(1):7–
17. https://journals.lww.com/mfm/fulltext/2021/01000/csog_mfm_committee_guideline__management_of.3.aspx
7. World Health Organization. WHO Guidelines on hepatitis B and C testing and antiviral prophylaxis in pregnancy. Geneva: WHO;
2021. https://www.ncbi.nlm.nih.gov/books/NBK561126
8. Wai CT, et al. A simple noninvasive index can predict both significant fibrosis and cirrhosis in patients with chronic hepatitis B.

Hepatology. 2003;38(2):518–526. https://pubmed.ncbi.nlm.nih.gov/12883497
9. Johnson PJ, et al. Assessment of liver function in patients with hepatocellular carcinoma: ALBI grade and score. J Clin Oncol.
2015;33(6):550–558. https://pubmed.ncbi.nlm.nih.gov/25512453
10. Wiseman E, et al. Perinatal transmission of hepatitis B virus: risk and prevention. J Hepatol. 2009;51(3):513–528. https://pub
med.ncbi.nlm.nih.gov/19560225
11. Pan CQ, et al. Tenofovir to prevent hepatitis B transmission in mothers with high viral load. N Engl J Med. 2016;374(24):2324–
2334. https://www.nejm.org/doi/full/10.1056/NEJMoa1508660
12. Liu J, et al. Maternal hepatic inflammation and risk of perinatal transmission of hepatitis B virus. Clin Infect Dis. 2020;71(3):681–689. https://pubmed.ncbi.nlm.nih.gov/31426260

1. World Health Organization. Prevention of mother-to-child transmission of hepatitis B virus: guidelines on antiviral prophylaxis
in pregnancy. Geneva: WHO; 2020. https://www.who.int/publications/i/item/978-92-4-000270-8
2. Tran TT, Ahn J, Reau NS. Treatment and prevention of viral hepatitis in pregnancy. Clin Liver Dis. 2021;25(2):237–254.
https://pmc.ncbi.nlm.nih.gov/articles/PMC8907340
3. European Association for the Study of the Liver (EASL). EASL Clinical Practice Guidelines: Management of chronic hepatitis
B virus infection. J Hepatol. 2023;79(1):S1–S33. https://www.journal-of-hepatology.eu/article/S0168-8278(23)00181-2/fulltext
4. Zhang J, et al. A scoping review of hepatitis B guidelines to reduce mother-to-child transmission. Lancet Reg Health West Pac.
2025;43:100772. https://pmc.ncbi.nlm.nih.gov/articles/PMC11772972
5. World Health Organization. Hepatitis B vaccines: WHO position paper. Wkly Epidemiol Rec. 2017;92(27):369–392.
https://www.who.int/publications/i/item/WER9227
6. Zhou YH, Hu Y, Liu X, Yang H; CSOG MFM Committee. CSOG MFM Committee Guideline: Management of Hepatitis B
During Pregnancy and Prevention of Mother-to-Child Transmission of Hepatitis B Virus (2020). Maternal Fetal Med. 2021;3(1):7–
17. https://journals.lww.com/mfm/fulltext/2021/01000/csog_mfm_committee_guideline__management_of.3.aspx
7. World Health Organization. WHO Guidelines on hepatitis B and C testing and antiviral prophylaxis in pregnancy. Geneva: WHO;
2021. https://www.ncbi.nlm.nih.gov/books/NBK561126
8. Wai CT, et al. A simple noninvasive index can predict both significant fibrosis and cirrhosis in patients with chronic hepatitis B.

Hepatology. 2003;38(2):518–526. https://pubmed.ncbi.nlm.nih.gov/12883497
9. Johnson PJ, et al. Assessment of liver function in patients with hepatocellular carcinoma: ALBI grade and score. J Clin Oncol.
2015;33(6):550–558. https://pubmed.ncbi.nlm.nih.gov/25512453
10. Wiseman E, et al. Perinatal transmission of hepatitis B virus: risk and prevention. J Hepatol. 2009;51(3):513–528. https://pub
med.ncbi.nlm.nih.gov/19560225
11. Pan CQ, et al. Tenofovir to prevent hepatitis B transmission in mothers with high viral load. N Engl J Med. 2016;374(24):2324–
2334. https://www.nejm.org/doi/full/10.1056/NEJMoa1508660
12. Liu J, et al. Maternal hepatic inflammation and risk of perinatal transmission of hepatitis B virus. Clin Infect Dis. 2020;71(3):681–689. https://pubmed.ncbi.nlm.nih.gov/31426260

1. World Health Organization. Prevention of mother-to-child transmission of hepatitis B virus: guidelines on antiviral prophylaxis
in pregnancy. Geneva: WHO; 2020. https://www.who.int/publications/i/item/978-92-4-000270-8
2. Tran TT, Ahn J, Reau NS. Treatment and prevention of viral hepatitis in pregnancy. Clin Liver Dis. 2021;25(2):237–254.
https://pmc.ncbi.nlm.nih.gov/articles/PMC8907340
3. European Association for the Study of the Liver (EASL). EASL Clinical Practice Guidelines: Management of chronic hepatitis
B virus infection. J Hepatol. 2023;79(1):S1–S33. https://www.journal-of-hepatology.eu/article/S0168-8278(23)00181-2/fulltext
4. Zhang J, et al. A scoping review of hepatitis B guidelines to reduce mother-to-child transmission. Lancet Reg Health West Pac.
2025;43:100772. https://pmc.ncbi.nlm.nih.gov/articles/PMC11772972
5. World Health Organization. Hepatitis B vaccines: WHO position paper. Wkly Epidemiol Rec. 2017;92(27):369–392.
https://www.who.int/publications/i/item/WER9227
6. Zhou YH, Hu Y, Liu X, Yang H; CSOG MFM Committee. CSOG MFM Committee Guideline: Management of Hepatitis B
During Pregnancy and Prevention of Mother-to-Child Transmission of Hepatitis B Virus (2020). Maternal Fetal Med. 2021;3(1):7–
17. https://journals.lww.com/mfm/fulltext/2021/01000/csog_mfm_committee_guideline__management_of.3.aspx
7. World Health Organization. WHO Guidelines on hepatitis B and C testing and antiviral prophylaxis in pregnancy. Geneva: WHO;
2021. https://www.ncbi.nlm.nih.gov/books/NBK561126
8. Wai CT, et al. A simple noninvasive index can predict both significant fibrosis and cirrhosis in patients with chronic hepatitis B.

Hepatology. 2003;38(2):518–526. https://pubmed.ncbi.nlm.nih.gov/12883497
9. Johnson PJ, et al. Assessment of liver function in patients with hepatocellular carcinoma: ALBI grade and score. J Clin Oncol.
2015;33(6):550–558. https://pubmed.ncbi.nlm.nih.gov/25512453
10. Wiseman E, et al. Perinatal transmission of hepatitis B virus: risk and prevention. J Hepatol. 2009;51(3):513–528. https://pub
med.ncbi.nlm.nih.gov/19560225
11. Pan CQ, et al. Tenofovir to prevent hepatitis B transmission in mothers with high viral load. N Engl J Med. 2016;374(24):2324–
2334. https://www.nejm.org/doi/full/10.1056/NEJMoa1508660
12. Liu J, et al. Maternal hepatic inflammation and risk of perinatal transmission of hepatitis B virus. Clin Infect Dis. 2020;71(3):681–689. https://pubmed.ncbi.nlm.nih.gov/31426260

Keywords
Pregnancy , Prevention , Hepatitis B Virus (HBV) , Vertical transmission , APRI , HBIG , Tenofovir
Для цитирования

Турсунбаева М.С. Факторы риска вертикальной передачи вируса гепатита B и эффективность различных схем профилактики у беременных.Научно-практический журнал«Здравоохранение Кыргызс- тана» 2025, № 4, с. 73-79. https://dx.doi.org/10.51350/zdravkg2025.4.12.9.73.79
For citation
Tursunbaeva M.S. Risk factors for vertical transmission of HBV infection and strategies for its prevention. Scientific practical journal “Health care of Kyrzstan” 2025, No.4, p. 73-79. https://dx.doi.org/10.51350/zdravkg2025.4.12.9.73.79
Цитата үчүн

Турсунбаева М.С. Кош бойлуу аялдарда В гепатит вирусунун вертикалдык жугушунун коркунуч факторлору жана алдын алуу ыкмаларынын натыйжалуулугу. "Кыргызстандын саламаттык сактоо" илимий-практикалык журналы
2025, № 4, б. 73-79. https://dx.doi.org/10.51350/zdravkg2025.4.12.9.73.79
Authors Tursunbaeva M.S.
Link doi.org https://dx.doi.org/10.51350/zdravkg2025.4.12.9.73.79
Pages 73-79
Keywords Pregnancy, Prevention, Hepatitis B Virus (HBV), Vertical transmission, APRI, HBIG, Tenofovir
Russian
Об авторах

Турсунбаева Мира Сабирбековна, ассистент кафедры инфекционных болезней Международной высшей школы медицины, Бишкек, Кыргызская Республика

Полный текст

PDF (RUS)
Список литературы

1. World Health Organization. Prevention of mother-to-child transmission of hepatitis B virus: guidelines on antiviral prophylaxis
in pregnancy. Geneva: WHO; 2020. https://www.who.int/publications/i/item/978-92-4-000270-8
2. Tran TT, Ahn J, Reau NS. Treatment and prevention of viral hepatitis in pregnancy. Clin Liver Dis. 2021;25(2):237–254.
https://pmc.ncbi.nlm.nih.gov/articles/PMC8907340
3. European Association for the Study of the Liver (EASL). EASL Clinical Practice Guidelines: Management of chronic hepatitis
B virus infection. J Hepatol. 2023;79(1):S1–S33. https://www.journal-of-hepatology.eu/article/S0168-8278(23)00181-2/fulltext
4. Zhang J, et al. A scoping review of hepatitis B guidelines to reduce mother-to-child transmission. Lancet Reg Health West Pac.
2025;43:100772. https://pmc.ncbi.nlm.nih.gov/articles/PMC11772972
5. World Health Organization. Hepatitis B vaccines: WHO position paper. Wkly Epidemiol Rec. 2017;92(27):369–392.
https://www.who.int/publications/i/item/WER9227
6. Zhou YH, Hu Y, Liu X, Yang H; CSOG MFM Committee. CSOG MFM Committee Guideline: Management of Hepatitis B
During Pregnancy and Prevention of Mother-to-Child Transmission of Hepatitis B Virus (2020). Maternal Fetal Med. 2021;3(1):7–
17. https://journals.lww.com/mfm/fulltext/2021/01000/csog_mfm_committee_guideline__management_of.3.aspx
7. World Health Organization. WHO Guidelines on hepatitis B and C testing and antiviral prophylaxis in pregnancy. Geneva: WHO;
2021. https://www.ncbi.nlm.nih.gov/books/NBK561126
8. Wai CT, et al. A simple noninvasive index can predict both significant fibrosis and cirrhosis in patients with chronic hepatitis B.

Hepatology. 2003;38(2):518–526. https://pubmed.ncbi.nlm.nih.gov/12883497
9. Johnson PJ, et al. Assessment of liver function in patients with hepatocellular carcinoma: ALBI grade and score. J Clin Oncol.
2015;33(6):550–558. https://pubmed.ncbi.nlm.nih.gov/25512453
10. Wiseman E, et al. Perinatal transmission of hepatitis B virus: risk and prevention. J Hepatol. 2009;51(3):513–528. https://pub
med.ncbi.nlm.nih.gov/19560225
11. Pan CQ, et al. Tenofovir to prevent hepatitis B transmission in mothers with high viral load. N Engl J Med. 2016;374(24):2324–
2334. https://www.nejm.org/doi/full/10.1056/NEJMoa1508660
12. Liu J, et al. Maternal hepatic inflammation and risk of perinatal transmission of hepatitis B virus. Clin Infect Dis. 2020;71(3):681–689. https://pubmed.ncbi.nlm.nih.gov/31426260
Для цитирования

Турсунбаева М.С. Факторы риска вертикальной передачи вируса гепатита B и эффективность различных схем профилактики у беременных.Научно-практический журнал«Здравоохранение Кыргызс- тана» 2025, № 4, с. 73-79. https://dx.doi.org/10.51350/zdravkg2025.4.12.9.73.79
English
About authors

Tursunbaeva Mira Sabirbekovna, Assistant, Department of Infectious Diseases, International Higher School of Medicine, Bishkek, Kyrgyz Republic
Full text

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References

1. World Health Organization. Prevention of mother-to-child transmission of hepatitis B virus: guidelines on antiviral prophylaxis
in pregnancy. Geneva: WHO; 2020. https://www.who.int/publications/i/item/978-92-4-000270-8
2. Tran TT, Ahn J, Reau NS. Treatment and prevention of viral hepatitis in pregnancy. Clin Liver Dis. 2021;25(2):237–254.
https://pmc.ncbi.nlm.nih.gov/articles/PMC8907340
3. European Association for the Study of the Liver (EASL). EASL Clinical Practice Guidelines: Management of chronic hepatitis
B virus infection. J Hepatol. 2023;79(1):S1–S33. https://www.journal-of-hepatology.eu/article/S0168-8278(23)00181-2/fulltext
4. Zhang J, et al. A scoping review of hepatitis B guidelines to reduce mother-to-child transmission. Lancet Reg Health West Pac.
2025;43:100772. https://pmc.ncbi.nlm.nih.gov/articles/PMC11772972
5. World Health Organization. Hepatitis B vaccines: WHO position paper. Wkly Epidemiol Rec. 2017;92(27):369–392.
https://www.who.int/publications/i/item/WER9227
6. Zhou YH, Hu Y, Liu X, Yang H; CSOG MFM Committee. CSOG MFM Committee Guideline: Management of Hepatitis B
During Pregnancy and Prevention of Mother-to-Child Transmission of Hepatitis B Virus (2020). Maternal Fetal Med. 2021;3(1):7–
17. https://journals.lww.com/mfm/fulltext/2021/01000/csog_mfm_committee_guideline__management_of.3.aspx
7. World Health Organization. WHO Guidelines on hepatitis B and C testing and antiviral prophylaxis in pregnancy. Geneva: WHO;
2021. https://www.ncbi.nlm.nih.gov/books/NBK561126
8. Wai CT, et al. A simple noninvasive index can predict both significant fibrosis and cirrhosis in patients with chronic hepatitis B.

Hepatology. 2003;38(2):518–526. https://pubmed.ncbi.nlm.nih.gov/12883497
9. Johnson PJ, et al. Assessment of liver function in patients with hepatocellular carcinoma: ALBI grade and score. J Clin Oncol.
2015;33(6):550–558. https://pubmed.ncbi.nlm.nih.gov/25512453
10. Wiseman E, et al. Perinatal transmission of hepatitis B virus: risk and prevention. J Hepatol. 2009;51(3):513–528. https://pub
med.ncbi.nlm.nih.gov/19560225
11. Pan CQ, et al. Tenofovir to prevent hepatitis B transmission in mothers with high viral load. N Engl J Med. 2016;374(24):2324–
2334. https://www.nejm.org/doi/full/10.1056/NEJMoa1508660
12. Liu J, et al. Maternal hepatic inflammation and risk of perinatal transmission of hepatitis B virus. Clin Infect Dis. 2020;71(3):681–689. https://pubmed.ncbi.nlm.nih.gov/31426260
For citation
Tursunbaeva M.S. Risk factors for vertical transmission of HBV infection and strategies for its prevention. Scientific practical journal “Health care of Kyrzstan” 2025, No.4, p. 73-79. https://dx.doi.org/10.51350/zdravkg2025.4.12.9.73.79
Kyrgyz
Авторлор жөнүндө

Турсунбаева Мира Сабирбековна, Эл аралык жогорку медицина мектебинин жугуштуу оорулар кафедрасынын ассистенти, Бишкек, Кыргыз Республикасы
Шилтемелер

1. World Health Organization. Prevention of mother-to-child transmission of hepatitis B virus: guidelines on antiviral prophylaxis
in pregnancy. Geneva: WHO; 2020. https://www.who.int/publications/i/item/978-92-4-000270-8
2. Tran TT, Ahn J, Reau NS. Treatment and prevention of viral hepatitis in pregnancy. Clin Liver Dis. 2021;25(2):237–254.
https://pmc.ncbi.nlm.nih.gov/articles/PMC8907340
3. European Association for the Study of the Liver (EASL). EASL Clinical Practice Guidelines: Management of chronic hepatitis
B virus infection. J Hepatol. 2023;79(1):S1–S33. https://www.journal-of-hepatology.eu/article/S0168-8278(23)00181-2/fulltext
4. Zhang J, et al. A scoping review of hepatitis B guidelines to reduce mother-to-child transmission. Lancet Reg Health West Pac.
2025;43:100772. https://pmc.ncbi.nlm.nih.gov/articles/PMC11772972
5. World Health Organization. Hepatitis B vaccines: WHO position paper. Wkly Epidemiol Rec. 2017;92(27):369–392.
https://www.who.int/publications/i/item/WER9227
6. Zhou YH, Hu Y, Liu X, Yang H; CSOG MFM Committee. CSOG MFM Committee Guideline: Management of Hepatitis B
During Pregnancy and Prevention of Mother-to-Child Transmission of Hepatitis B Virus (2020). Maternal Fetal Med. 2021;3(1):7–
17. https://journals.lww.com/mfm/fulltext/2021/01000/csog_mfm_committee_guideline__management_of.3.aspx
7. World Health Organization. WHO Guidelines on hepatitis B and C testing and antiviral prophylaxis in pregnancy. Geneva: WHO;
2021. https://www.ncbi.nlm.nih.gov/books/NBK561126
8. Wai CT, et al. A simple noninvasive index can predict both significant fibrosis and cirrhosis in patients with chronic hepatitis B.

Hepatology. 2003;38(2):518–526. https://pubmed.ncbi.nlm.nih.gov/12883497
9. Johnson PJ, et al. Assessment of liver function in patients with hepatocellular carcinoma: ALBI grade and score. J Clin Oncol.
2015;33(6):550–558. https://pubmed.ncbi.nlm.nih.gov/25512453
10. Wiseman E, et al. Perinatal transmission of hepatitis B virus: risk and prevention. J Hepatol. 2009;51(3):513–528. https://pub
med.ncbi.nlm.nih.gov/19560225
11. Pan CQ, et al. Tenofovir to prevent hepatitis B transmission in mothers with high viral load. N Engl J Med. 2016;374(24):2324–
2334. https://www.nejm.org/doi/full/10.1056/NEJMoa1508660
12. Liu J, et al. Maternal hepatic inflammation and risk of perinatal transmission of hepatitis B virus. Clin Infect Dis. 2020;71(3):681–689. https://pubmed.ncbi.nlm.nih.gov/31426260
Цитата үчүн

Турсунбаева М.С. Кош бойлуу аялдарда В гепатит вирусунун вертикалдык жугушунун коркунуч факторлору жана алдын алуу ыкмаларынын натыйжалуулугу. "Кыргызстандын саламаттык сактоо" илимий-практикалык журналы
2025, № 4, б. 73-79. https://dx.doi.org/10.51350/zdravkg2025.4.12.9.73.79
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