Clara Costa Mendes¹, Carolina de Mello Viera¹, Vitória Sakai¹, Luiza Atanazio¹, João Pedro Zortea da Campo² and Liliana Sampaio Costa Mendes³*

¹Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
²Hospital Tacchini, Bento Gonçalves, Rio Grande do Sul, Brazil
³Hospital DF Star - Rede D´or São Luiz, Brasília, Distrito Federal, Brazil

*Corresponding Author: Liliana Sampaio Costa Mendes, Hospital DF Star - Rede D´or São Luiz, Brasília, Distrito Federal, Brazil.

Received: September 04, 2026; Published: October 14, 2026

Chronic hepatitis B (CHB) remains a major public health problem, and during pregnancy it carries particular significance because of the risk of vertical transmission, which in most cases occurs during labour and delivery. Although pregnancy is generally well tolerated in women with hepatitis B virus (HBV) infection, the peripartum and postpartum periods may be associated with hepatic flares, and the absence of neonatal prophylaxis results in a substantial burden of new infections. This narrative review synthesises current evidence on the clinical management of CHB in pregnancy, with emphasis on the pathophysiology of HBV infection in gestation, initial maternal assessment, stratification of the risk of vertical transmission, universal antenatal screening, indications for and timing of antiviral therapy, the antivirals available during pregnancy, intrapartum and delivery management, breastfeeding, neonatal prophylaxis and maternal postpartum follow-up. The maternal viral load and hepatitis B e antigen (HBeAg) status are the principal determinants of transmission risk, and antiviral prophylaxis with tenofovir, initiated in the late second or third trimester in women with HBV DNA above 200,000 IU/mL, is an effective adjunct to neonatal immunoprophylaxis. Timely administration of the hepatitis B vaccine and hepatitis B immunoglobulin to the exposed newborn remains the cornerstone of prevention. Care should be understood as a continuous pathway extending from antenatal screening through delivery, the neonatal period, breastfeeding and long-term maternal and infant follow-up, requiring coordinated multidisciplinary management to support the goal of eliminating hepatitis B as a public health threat.

Keywords

Chronic hepatitis B; Pregnancy; Vertical transmission; Antiviral prophylaxis; Tenofovir; Neonatal Immunoprophylaxis

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Citation

Citation: Liliana Sampaio Costa Mendes. et al. “Management of the Pregnant Woman with Chronic Hepatitis B: A Literature Review". Acta Scientific Gastrointestinal Disorders 9.3 (2026): 40-49.

Copyright

Copyright: © 2026 Liliana Sampaio Costa Mendes. et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.