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Unexplained Fever in Obstetrics
Published in Benedict Isaac, Serge Kernbaum, Michael Burke, Unexplained Fever, 2019
Hepatitis A4 has no teratogenic effect, and transplacental transmission is rare. There is an increased risk of prematurity and abortions. Pregnant women, as any adult, tend to have a more serious disease than children. Immunoglobulin should be given to the exposed mother as soon as possible and to her offspring immediately after birth. Hepatitis B is a much more serious disease during pregnancy and newborns of carrier mothers, positive for “e” and surface antigens have an 80 to 90% chance of becoming infected. Ninety percent of these infants become chronic carriers and 25% of them will eventually die of chronic liver disease. As in hepatitis A, the disease has a more severe course during pregnancy and can cause an increased rate of abortions and prematurity. As only 5% of the newborns are infected by the transplacental route, the disease in the infant can theoretically be prevented. The infant is given hepatitis B immune globulin and hepatitis B vaccine. This combination is effective in preventing the disease in 90% of cases.9
Risks and Adverse Reactions Associated with Hemapheresis
Published in James L. MacPherson, Duke O. Kasprisin, Therapeutic Hemapheresis, 2019
Hepatitis is a hazard whenever plasma is used as the replacement medium in whole or in part;11 how often it occurs is unknown. Two deaths have been reported from it.612 There is probably no way of avoiding this complication, other than that of using plasma as the replacement medium only when it is specifically indicated (e.g., in thrombotic thrombocytopenic purpura). Neither hepatitis B immune globulin nor the vaccine would be likely to be effective, since most posttransfusion hepatitis is of the non-A/non-B type, which also cannot be adequately screened by plasma donor testing procedures.
Viral hepatitis.
Published in Michael JG Farthing, Anne B Ballinger, Drug Therapy for Gastrointestinal and Liver Diseases, 2019
Eleanor Barnes, George Webster, Geoffrey M Dusheiko
The following preventative approaches have been successful for prophylaxis of hepatitis B: Hepatitis B immunoglobulinHepatitis B vaccine.
A decrease in functional microbiomes represented as Faecalibacterium affects immune homeostasis in long-term stable liver transplant patients
Published in Gut Microbes, 2022
Soon Kyu Lee, JooYeon Jhun, Seung Yoon Lee, Sukjung Choi, Sun Shim Choi, Myeong Soo Park, Seon-Young Lee, Keun-Hyung Cho, A Ram Lee, Joseph Ahn, Ho Joong Choi, Young Kyoung You, Pil Soo Sung, Jeong Won Jang, Si Hyun Bae, Seung Kew Yoon, Mi-La Cho, Jong Young Choi
The clinical and demographic parameters of 22 long-term post-LT patients and five tolerant patients included in the study are summarized in Table 1. The mean age was 63.0 ± 6.8 y, and 48.1% (n = 13) of patients were male. Living donor LT accounted for about 74% of the included patients, and hepatitis B virus-associated liver disease (n = 25, 92.6%) was the most common cause of LT. Of the 22 long-term post-LT patients, 17 patients (77.3%) ingested tacrolimus with a mean dose of 2.1 ± 0.9 mg per day. The other 5 patients (22.7%) ingested cyclosporine (mean dosage, 115.0 ± 33.5 mg/day). All 27 patients had a normal liver function, including aspartate transaminase (AST), alanine transaminase (ALT), albumin, and total bilirubin levels. The mean time after LT of 27 included patients was 13.2 ± 4.9 y without significant difference between the two groups. Twenty-five patients who had hepatitis B virus-associated liver disease before LT showed negative HBsAg with positive HBsAb after LT (Supplementary table 1). All those 25 patients ingested antiviral agents (n = 22, entecavir; n = 1, tenofovir; n = 2, lamivudine) and, of them, 21 patients also received hepatitis B immune globulin every 2–3 months. No patients experienced reactivation of hepatitis B during follow-up.
Novel developments of hepatitis B: treatment goals, agents and monitoring tools
Published in Expert Review of Clinical Pharmacology, 2019
Lung-Yi Mak, Wai-Kay Seto, James Fung, Man-Fung Yuen
The age of HBV infection determines the risk of chronicity: for infants and children <1 year old, the risk is >90%, compared to 30% in children aged 1–5, and even lower for adults (0–2%) [5,6]. Therefore, children <5 year old account for the majority of newly acquired CHB infection. Vaccination in this age group is of utmost importance for reduction of new infections and thus primary prevention of CHB-related complications. In the 1990s, the World Health Assembly recommended the inclusion of the HBV vaccine in the routine infant immunization schedules. The HBV vaccine is safe and effective [7]. The first dose should be given ideally within 24 h of birth, followed by the second and third dose in the initial few months from birth depending on regional policy [8]. In some countries, passive immunization with hepatitis B immune globulin is also given concomitantly with the birth dose vaccine in newborns of CHB mothers, which is recommended to be given within 12 h of birth. The immunologic memory remains intact for at least 30 years in >90% of healthy vaccinated individuals who were vaccinated beyond 6 months of age [9] and at least up to 17 years for those vaccinated in early infancy [10].
Prevention of viral infections in solid organ transplant recipients in the era of COVID-19: a narrative review
Published in Expert Review of Anti-infective Therapy, 2022
Paraskevas Filippidis, Julien Vionnet, Oriol Manuel, Matteo Mombelli
In liver transplant recipients with chronic HBV infection, lifelong antiviral treatment with an NA with a high genetic barrier to resistance, such as entecavir or tenofovir, is universally recommended because of the high risk of posttransplant HBV recurrence [175]. Concomitant administration of hepatitis B immunoglobulin (HBIG) for 5–7 days after liver transplantation may also be considered for these patients, although an HBIG-free antiviral prophylaxis can be highly successful in the era of NA with high barrier to resistance [176]. Long-term (≥ 1 year) HBIG administration along with NA is usually warranted in patients with HBV-HIV or HBV-HDV co-infection because of a higher risk for poor outcome and limited rescue therapies available if HBV recurs [175].