Breastfeeding by Hepatitis B Virus-infected Women
Decades ago, studies from the Far East demonstrated that HBsAg could be detected in breast milk in a large proportion of HBV-infected women.[48,49] Because many infants became infected before the availability of immunization, there was concern about the additional risk that breastfeeding might confer. However, around the same time, Beasley et al. reported 53% HBV infection in breastfed vs 60% in formula-fed infants. More recently, several studies have documented no difference in rates of perinatal infection between breastfed and formula-fed vaccinated infants, which was between 0 and 5% in both groups, although many of the women in these studies were HBeAg negative.[51,52] These data support the recommendation of the American Academy of Pediatrics that HBV infection not be considered a contraindication to breastfeeding of infants who receive the HBIG and HBV vaccine as advised. In addition, it appears that breastfeeding does not interfere with the immune response to the HBV vaccine. In one group of 230 infants, the rate of anti-HBs at 1 year of age was 80.9% in breastfed compared with 73.2% in formula-fed infants who received the HBV vaccine alone, and 90.9 vs 90.3% in those who received the HBV vaccine and HBIG. It may be prudent, however, to counsel against breastfeeding by women receiving antiviral agents, because the safety of these drugs during lactation has not been demonstrated.
Liver International. 2009;29(s1):133-139. © 2009
Cite this: Hepatitis B and Pregnancy: An Underestimated Issue - Medscape - Jan 01, 2009.