World Hepatitis Day - 28th July 2023 Viral Hepatitis & Pregnancy

What is Hepatitis & its types?

Viral Hepatitis is a systemic infection affecting liver predominantlyby any one of the hepatitis viruses. Most common viruses causingHepatitis are Hepatitis A, B, C, D, E and G. Other less commoncauses of Hepatitis are caused by Cytomegalovirus, Epstein-Barr virus, Herpes Simplex virus and Falciparum Malaria. 0n exposure tothe virus, about two-thirds of patients do not develop any symptoms.Others may develop fulminant and fatal acute infections on one hand, and from subclinical persistent infections to rapidly progressive chronic Liver disease leading to Cirrhosis and Hepatocellular Carcinoma.

How does Viral hepatitis spread?

Hepatitis A (HAV)

It spreads through the feco-oral pathway and is linked to poorsanitary conditions. HAV infection is frequent in underdevelopedcountries such as India during childhood, resulting in mild hepatitisand posing little danger during pregnancy.

Hepatitis B (HBV)

HBV is transmitted through needle stick injuries, tattooing, piercing,and contact with contaminated blood and body fluids such as saliva,vaginal and seminal secretions. Acute infection is manifested by flu-like symptoms. Approximately 90% of individuals have spontaneousresolution of acute infection, 5-10% would become chronic carriers.

It is often transmitted from mother to child at birth (perinataltransmission) or through exposure to maternal blood, vaginalsecretions during delivery or acquired during breastfeeding. If apatient tests positive for Hepatitis B virus, HBV antiviral medicationshould be continued during the pregnancy and after delivery.

Pregnant women may experience fatigue, nausea and vomiting,abdominal pain or discomfort, loss of appetite, low-grade fever, dark urine, and joint pain. In addition the routine screening for Hepatitis Bis done in pregnant women.

Hepatitis E

HEV can also be transmitted through feco-oral route. Pregnantwomen with Hepatitis E, especially those in their second or thirdtrimesters, are at increased risk of acute liver failure, foetal loss anddeath.

How Viral Hepatitis affect pregnant women ?

In most cases , acute or chronic HBV infection in pregnancy is not different from that occurring in non- pregnant women. Outcome of maternal infection is strictly dependent upon the stage of the disease.Patients with advanced disease may develop jaundice, rupture ofoesophageal varices, liver failure.

Maternal infection with viral Hepatitis can lead to increasedincidence of low birth weight and preterm births. During yourpregnancy, pregnant women undergo blood tests for 3 infectiousdiseases: hepatitis B, HIV and syphilis. Babies born to a mother withhepatitis B have a greater chance of developing chronic hepatitis ifthey are not properly treated at birth. It is very important thatpregnant people know their hepatitis status in order to prevent passing the virus on to their newborn baby during delivery.

What are the preventive measures for Viral Hepatitis?

Improving hygiene conditions and providing safe, clean drinkingwater helps in preventing HAV and HEV spread. Active screening ofhigh-risk groups for HBV, HCV infection helps in identifyingcarriers and preventing community transmission.

Awareness about Viral Hepatitis, their modes transmission andpreventive measures among community helps to curb these infections.

In addition, screening of blood and blood products, as well as routinetesting of tissue and organ donors, are part of the HHBV and HCV infection prevention approach.

Vaccination is the most effective method of preventing HAV andHBV because these are vaccine-preventable diseases.

What is Hepatitis & its types?

Viral Hepatitis is a systemic infection affecting liver predominantlyby any one of the hepatitis viruses. Most common viruses causingHepatitis are Hepatitis A, B, C, D, E and G. Other less commoncauses of Hepatitis are caused by Cytomegalovirus, Epstein-Barr virus, Herpes Simplex virus and Falciparum Malaria. 0n exposure tothe virus, about two-thirds of patients do not develop any symptoms.Others may develop fulminant and fatal acute infections on one hand, and from subclinical persistent infections to rapidly progressive chronic Liver disease leading to Cirrhosis and Hepatocellular Carcinoma.

How does Viral hepatitis spread?

Hepatitis A (HAV)

It spreads through the feco-oral pathway and is linked to poorsanitary conditions. HAV infection is frequent in underdevelopedcountries such as India during childhood, resulting in mild hepatitisand posing little danger during pregnancy.

Hepatitis B (HBV)

HBV is transmitted through needle stick injuries, tattooing, piercing,and contact with contaminated blood and body fluids such as saliva,vaginal and seminal secretions. Acute infection is manifested by flu-like symptoms. Approximately 90% of individuals have spontaneousresolution of acute infection, 5-10% would become chronic carriers.

It is often transmitted from mother to child at birth (perinataltransmission) or through exposure to maternal blood, vaginalsecretions during delivery or acquired during breastfeeding. If apatient tests positive for Hepatitis B virus, HBV antiviral medicationshould be continued during the pregnancy and after delivery.

Pregnant women may experience fatigue, nausea and vomiting,abdominal pain or discomfort, loss of appetite, low-grade fever, dark urine, and joint pain. In addition the routine screening for Hepatitis Bis done in pregnant women.

Hepatitis E

HEV can also be transmitted through feco-oral route. Pregnantwomen with Hepatitis E, especially those in their second or thirdtrimesters, are at increased risk of acute liver failure, foetal loss anddeath.

How Viral Hepatitis affect pregnant women ?

In most cases , acute or chronic HBV infection in pregnancy is not different from that occurring in non- pregnant women. Outcome of maternal infection is strictly dependent upon the stage of the disease.Patients with advanced disease may develop jaundice, rupture ofoesophageal varices, liver failure.

Maternal infection with viral Hepatitis can lead to increasedincidence of low birth weight and preterm births. During yourpregnancy, pregnant women undergo blood tests for 3 infectiousdiseases: hepatitis B, HIV and syphilis. Babies born to a mother withhepatitis B have a greater chance of developing chronic hepatitis ifthey are not properly treated at birth. It is very important thatpregnant people know their hepatitis status in order to prevent passing the virus on to their newborn baby during delivery.

What are the preventive measures for Viral Hepatitis?

Improving hygiene conditions and providing safe, clean drinkingwater helps in preventing HAV and HEV spread. Active screening ofhigh-risk groups for HBV, HCV infection helps in identifyingcarriers and preventing community transmission.

Awareness about Viral Hepatitis, their modes transmission andpreventive measures among community helps to curb these infections.

In addition, screening of blood and blood products, as well as routinetesting of tissue and organ donors, are part of the HHBV and HCV infection prevention approach.

Vaccination is the most effective method of preventing HAV andHBV because these are vaccine-preventable diseases.

Dr. Dharshitha Varigonda

Consultant General Physician,

Apollo Cradle & Children’s Hospital, Kondapur.