Pregnant people with Hep B

hi all! I am curious about your experiences if you got your diagnosis before or during pregnancy.

I recently got diagnosed and I am trying to understand how the virus will afect my potential pregnancies and child birth. I am 31F and single, not even trying to conceive atm but I want to hear from you.

  • what are the potential risks for the baby?
  • are there any special needs for you as pregnant person with Hep b?

I appreciate that with the current medical advances, this disease is no longer a death sentence but I want to be aware of the implications of the virus for my life.

thanks for your help

-A

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hello,
I had 3 c section pregnancies. I did not check my viral load at the time and was told that the babies need to get vaccines. I had all of my kids receive vaccines at the time of their births. Unfortunately the second one has hbv which we found out 18 years later during the process of blood donation. We were shocked. I thought we checked all of our kids whether they were protected or not and got the 3 series of vaccines and naively assumed everything was ok when the pediatrician told us all was fine. Professionals like MD make mistakes despite the fact that I had crystal clearly told them of my situation. I was too dumb and naive to take his words and did not fully investigate and double check. Now I know that some MDs are not that competent. I don’t know what else could have been done. My guess is that if we were able to give our second one a booster vaccines at the age of 1 or so it could have made the difference of becoming chronic or not. I gave my third child a booster shot when her pediatrian said she may need one. At the time, I didn’t know what it was but just followed his direction. Looking back, that could have worked for my second one. In this case, the doctor was extremely competent to guide me to the right direction.
Anyway, I thought the c section could have helped in not becoming chronic for my child but it did not work. It could be the skill of the obgyn or perhaps it is statistics. My first doctor was very competent but the second doctor who delivered my second and third child was not very good. We had to move after the first child so I had to change the doctor.

I’ve read that if you take antiviral before the delivery, it could help because your dna will be extremely low preventing transmissions of the virus. Lesson here is take double precautions. Always double check even if the doctor says it is all good. You need to go beyond and take a second confirmation before assuming anything.
hope this helped.

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You mean pregnant women ?

Thank you very much for sharing your story and I’m sorry to hear what happened with your second pregnancy. I think it’s great advice what you say about the antivirals and doing your best to double check about the full series of the vaccines.

-A

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Thanks @ale92 for your question and @catcher.007 for bravely sharing your story.

I’m sorry that your 2nd child was found to be HBV positive. It’s not clear if it was vaccine failure (5-15% of cases) and/or high virus exposure in this case. As you rightly mention, if the mother’s viral load is high then there are recommendations to use antiviral treatment to reduce the potential exposure to the new-born and/or to give the new-born HBIG to prevent infection. Caesarean births may decrease the exposure to the virus according to some meta-analyses (https://doi.org/10.1155%2F2014%2F350179 and Elective caesarean section versus vaginal delivery for preventing mother to child transmission of hepatitis B virus – a systematic review | Virology Journal | Full Text), but it is also depends on many other factors.

Hope this answers your questions, @ale92

Cheers,
Thomas

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Hi there,
I have had 2 children in the last 9 years during which time both children were vaccinated since birth and then underwent the routine national Australian immunisation protocol which includes Hepatitis B at 2, 4 and 6 months. The first child underwent blood testing at 2.5 years of age and found to be fully vaccinated against Hep B. The second is now 3 but not had a blood test to check immunity as yet. There doesn’t appear to be a protocol when exactly immunity is checked for as my first only had it checked when she needed to have bloods checked for another medical condition.

Apparently it is recommended that Hep B+ pregnant women undergo viral load testing in the 3rd trimester to see whether antiviral medication is required to reduce the load and reduce the small percentage of children who could still develop Hep B even after being vaccinated at birth.

Here is the link: https://ranzcog.edu.au/wp-content/uploads/2022/05/Management-of-Hepatitis-B-in-pregnancy-C-Obs-50.pdf

However my viral load was not checked at either pregnancy (with two different Australian obstetricians) and I was not offered any antiviral prophylaxis. As patients we trust that our health care provider knows best and at the time I was not aware of having one’s viral load checked in the 3rd trimester otherwise I’m sure many of us would want it done to prevent transmission - as a mother you want to try and do the best for your child but if it is not offered in the first place how can we do this?

@cather.007 I’m so sorry to hear this situation and it is something I’m hoping not to hear. My youngest is a boy and I don’t feel he is ready to undergo having an invasive blood test to check on his status as yet. Did anyone follow-up with you to have your children’s status checked after being vaccinated?

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Hello there, i’m 27 year olds and found out I have hep B during my first pregnancy which was last year. As soon as my ob found out she referred me to GI specialist and i went to countless of blood tests to monitor throughout my pregnancy and start taking tenofovir right away. My son was born via c section, he received all of hep b vaccines which is at birth, 2 months, 6 months. Then at 9 months he had a blood test done to see if he’s immune to hep b. He is all happy and healthy. I think for the most part if your baby receive all of the recommended vaccines and follow a blood to see if the vaccine works then it should be fine. In a rare case maybe they need a booster - at least that’s what I was told. Wish you all the best!

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no, the doctors did not tell me to do a follow up for my second and third. I think we had to do a blood work for my third for some other reason and came across ambiguous situation with hbv status and I was told to have her get a booster. She is fine. It’s the second one who never received the booster. I wish the pediatricians and the obgyn were more careful and cautious with my situation. My first obgyn was extremely cautious when performing c section and he really paid attention to my first child to avoid any chance. But the second obgyn was not so careful who delivered my second and third. Mostly, I should have pressed on to double check instead of putting too much trust. It was my life’s biggest mistake.

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Yes I think there is a gap there.

There is a lot for everyone to have to remember - on both the side of the mother undergoing birth as well as the obstetrician. It would’ve been so good to have an automated reminder sent out because a long time passes before anyone remembers about having a follow-up blood test… It was the same with my first - she just happened to need a blood test for something else so they added it to check which seems more of an afterthought and I wasn’t aware of the importance of checking - just kind of assumed the vaccination would automatically work and protect… I think I will need to try and get the youngest tested soon as I also have this lingering fear at the back of my mind “what if he’s not protected”. I share your worry about being one of life’s biggest mistakes - something that could’ve been so easily avoided and a feeling of guilt and failure as a mother to protect your child. I wonder how we can change the system…