| Evaluation and management of hepatitis B in pregnancy: a survey of current practices. | |
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MedLine Citation:
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PMID: 21088746 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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Background: Optimal management of hepatitis B (HBV) during pregnancy is unclear. Safety and efficacy data of antiviral therapy are limited. We assessed the practice patterns of hepatologists, gastroenterologists, and other physicians for evaluating and managing pregnant patients with HBV as well as the variation of these practice patterns by primary specialty and practice description. Methods: An 18-question electronic survey was sent to physicians with a special interest in liver disease addressing the evaluation and management of HBV during pregnancy. Results: A total of 226 physicians responded, of whom 68.5% characterized their primary specialty as hepatology, 26.5% as gastroenterology, and 4.9% as other; 62.4% were academic-based physicians, and 37.6% were community-based physicians. The average years in practice were 13.3. Initiation of antiviral therapy during pregnancy was supported by 51.8% of respondents. Of those against therapy initiation, 60.4% cited a lack of clear recommendations, 32.1% cited safety concerns, and 7.5% cited a lack of efficacy. For patients on antivirals who desired to become pregnant, 74.8% of respondents would continue antiviral therapy. The most common antiviral used in pregnancy was lamivudine (72.1%). HBV vaccination and HBV immunoglobulin for infants born to mothers with HBV were recommended by 98.7% of respondents; 57.5% would also recommend breastfeeding. If antivirals were being used, only 30.5% of respondents would still recommend breastfeeding. More hepatologists were "very comfortable" (P=.032) managing these patients compared to nonhepatologists. Conclusions: There is significant heterogeneity in the management of pregnant patients with HBV regardless of primary specialty or practice description. This variability likely reflects a lack of data and specific guidelines. Further research and more specific guidelines are needed. |
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Authors:
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Joseph Ahn; Suhail B Salem; Stanley Martin Cohen |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Gastroenterology & hepatology Volume: 6 ISSN: 1554-7914 ISO Abbreviation: Gastroenterol Hepatol (N Y) Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-11-22 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101262648 Medline TA: Gastroenterol Hepatol (N Y) Country: United States |
Other Details:
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Languages: eng Pagination: 570-8 Citation Subset: - |
Affiliation:
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Dr. Ahn serves as Assistant Professor of Medicine and Medical Director of Liver Transplantation at Loyola University Medical Center in Maywood, Illinois. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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