Journal article
Incidence, determinants and outcomes of pregnancy-associated hepatitis B flares: A regional hospital-based cohort study
Liver international, v 38(5), pp 813-820
May 2018
PMID: 28941137
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
There is limited knowledge about hepatitis B virus (HBV) flare among pregnant women. We evaluated the incidence, determinants and outcomes of HBV flare in a multicultural cohort of pregnant HBV-infected women in the United States.
We performed a retrospective cohort study of pregnant hepatitis B surface antigen-positive women cared for at hospital-based clinics of 4 medical centres in Southeastern Pennsylvania from 2006 to 2015. The main outcome was incident HBV flare (alanine aminotransferase [ALT] ≥2 times upper limit of normal) during pregnancy or within 6 months after delivery. Among patients with flare, we determined development of jaundice (total bilirubin ≥2.5 mg/dL) and hepatic decompensation. Multivariable logistic regression was used to estimate odds ratios (ORs) of HBV flare for risk factors of interest, including timing of flare (during pregnancy versus post-delivery), nulliparity, younger age, HBV e antigen (HBeAg) status, and lack of anti-HBV therapy.
Among 310 pregnant predominantly African HBV-infected women with 388 pregnancies, the incidence of HBV flare was 14% (95% CI, 10-18%) during pregnancy and 16% (95% CI, 11-24%) post-delivery. Jaundice developed in 12% and hepatic decompensation in 2%. Positive HBeAg was associated with HBV flare (OR, 2.55; 95% CI, 1.04-6.20). HBV DNA was measured in 55% of patients, and only 50% were referred for HBV specialty care.
Pregnancy-associated hepatitis B flare occurred in 14% during pregnancy and 16% post-delivery and rarely led to hepatic decompensation. Positive HBeAg was the main risk factor identified. Women did not have adequate HBV monitoring or follow-up during pregnancy.
Metrics
Details
- Title
- Incidence, determinants and outcomes of pregnancy-associated hepatitis B flares: A regional hospital-based cohort study
- Creators
- Tatyana Kushner - Raymond and Ruth Perelman School of Medicine at the University of PennsylvaniaPamela A Shaw - Raymond and Ruth Perelman School of Medicine at the University of PennsylvaniaAnkush Kalra - Thomas Jefferson UniversityLora Magaldi - Drexel UniversityPooja Monpara - Drexel UniversityGurneet Bedi - Penn State Milton S. Hershey Medical CenterKaren Krok - Penn State Milton S. Hershey Medical CenterSierra Centkowski - Raymond and Ruth Perelman School of Medicine at the University of PennsylvaniaKatherine Dalldorf - Raymond and Ruth Perelman School of Medicine at the University of PennsylvaniaJulia D'souza - Raymond and Ruth Perelman School of Medicine at the University of PennsylvaniaDina Halegoua-De Marzio - Thomas Jefferson UniversityDavid S Goldberg - University of PennsylvaniaStacey Trooskin - Drexel UniversityLisa D Levine - Hospital of the University of PennsylvaniaSindhu K Srinivas - Hospital of the University of PennsylvaniaJames D Lewis - Raymond and Ruth Perelman School of Medicine at the University of PennsylvaniaKimberly A Forde - Raymond and Ruth Perelman School of Medicine at the University of PennsylvaniaVincent Lo Re, 3rd - Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania
- Publication Details
- Liver international, v 38(5), pp 813-820
- Publisher
- Wiley
- Number of pages
- 8
- Grant note
- T32 DK007740 / NIDDK NIH HHS K24 DK078228 / NIDDK NIH HHS K23 DK090209 / NIDDK NIH HHS R21 AI124868 / NIAID NIH HHS
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Infectious Diseases (and HIV Medicine)
- Web of Science ID
- WOS:000435855300008
- Scopus ID
- 2-s2.0-85030677436
- Other Identifier
- 991019170148704721
UN Sustainable Development Goals (SDGs)
This publication has contributed to the advancement of the following goals:
InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Gastroenterology & Hepatology