Patient's question:
In recent months, I've noticed that I have little appetite when eating and don't consume much food. Additionally, I feel nauseous when eating greasy things, and sometimes I also have high fever. When I went to the hospital for a check-up, the diagnosis was "minor hepatitis B," but I still want to have children.Doctor's answer:
Hello: Patients with minor hepatitis B (HBsAg positive) can normally become pregnant. Pre-pregnancy testing should be conducted, including HBV DNA testing, liver function tests, and ultrasound examinations. Pregnancy is only recommended if the HBV DNA test is negative and liver function is normal. Additionally, maternal-fetal transmission prevention should be implemented, which involves monthly injections of high-titer hepatitis B immune globulin during the 7th, 8th, and 9th months of pregnancy, with a dosage of 200 units each time, to prevent intrauterine transmission.If the HBV DNA quantification value is less than 1.00E+03, maternal-fetal transmission prevention can be performed after the baby is born. The method is as follows: Within 24 hours of birth, the baby should receive one injection of high-titer hepatitis B immune globulin (100 units). Simultaneously, the baby should be vaccinated with hepatitis B vaccine (10 mg dose). One month later, the baby should receive another dose of hepatitis B vaccine (10 mg), and six months later, another dose of hepatitis B vaccine (10 mg). This completes the full course of maternal-fetal transmission prevention, with an effectiveness rate of over 90%.
Post-pregnancy Guidance: For hepatitis B-positive women with positive HBV DNA, it is recommended to avoid breastfeeding as much as possible. The reasons are as follows:
1. Breast milk from HBV-positive mothers may contain hepatitis B virus. If the baby causes nipple damage while breastfeeding, transmission may occur. Additionally, if the baby has damaged oral or gastrointestinal mucosa during breastfeeding, transmission is also possible. Therefore, breastfeeding is not recommended.
2. Currently, many experts nationwide believe that hepatitis B-positive mothers can breastfeed. However, based on our 20 years of research, we have found that the milk of hepatitis B-positive mothers is not highly nutritious. This is because patients with hepatitis have a reduced ability to synthesize various proteins needed by the body. The milk produced by hepatitis B-positive mothers lacks many proteins and other nutrients essential for infants. Even without considering transmission, breastfeeding may not guarantee adequate nutrition for the baby. Additionally, the loss of protein from the mother's body may worsen or accelerate the progression of the hepatitis B condition.