Patient's question:
The man is an HBV carrier, the woman has antibodies, and she is pregnant. Does the woman need prenatal screening? What does prenatal screening mainly check for?Doctor's answer:
Most hepatitis B virus infections occur during childbirth when the mother is positive, transmitting the virus to the newborn through blood. Administering the hepatitis B vaccine to newborns can effectively prevent the majority of infections. After newborns are infected with the hepatitis B virus, in most cases, they remain asymptomatic carriers, meaning the virus persists in their bodies without causing significant liver damage, and the alanine aminotransferase (ALT) levels, which reflect liver cell damage, are also not elevated. This state can last for many years, and a small number of children may naturally clear the virus from their bodies. If, during childhood, there is only hepatitis B virus infection with no abnormal ALT levels, do not blindly pursue treatment. The main factor or cause is that, with currently available medications, there is no ideal method to completely eliminate the virus. Additionally, the child's immune system is also in a tolerant state, making it difficult to clear the virus. However, if the doctor confirms that recurrent hepatitis is caused by hepatitis B virus infection, it is important to seek medical treatment promptly to control the progression of the disease as soon as possible. In terms of treatment, one approach is to use liver-protecting and enzyme-lowering drugs for symptomatic treatment, while the other option is to consider antiviral therapy. Children respond to interferon treatment similarly to adults, with comparable efficacy and tolerance. At standard doses and treatment durations, no more significant side effects are observed in children than in adults. In summary, since treating hepatitis B infection in childhood does not yield better outcomes than in adulthood, antiviral or immunomodulatory treatments should not be pursued unless there are clear signs of liver damage. Moreover, it is especially important not to self-prescribe or use medications without medical guidance.