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Viral hepatitis are acute or chronic infections caused by viruses with liver tropism. Viral hepatitis' profilaxy and treatment can prevent cirrhosis, end‑stage liver disease or hepatocellular carcinoma. Hepatitis A and hepatitis B vaccines are currently available. Pre- and especially post-exposure hepatitis B prophylaxis is given by administration of anti-hepatitis B immunoglobulin. The treatment of chronic hepatitis B is done with interferons or nucleoside/nucleotide analogues. Antivirals are sometimes given for long periods because the hepatitis B virus cannot be eradicated with currently existing medication. In contrast, recent therapeutic advances allow a sustained virological response in over 90% of treated patients. Currently, the treatment of chronic hepatitis C is done with direct-acting antivirals, possibly associated with ribavirin, in most cases the administration of interferon being no longer necessary. [ABSTRACT FROM AUTHOR]

The management of hepatitis B virus (HBV) during pregnancy remains a challenge and involves various aspects of maternal-fetal care. Our objective is to provide a comprehensive review of the current knowledge regarding pregnancy and HBV infection, as well as recent efforts to reduce the rate of motherto- child transmission (MTCT). We also present the 2016 clinical experience with HBV positive patients. We analysed data from 43 HBV positive pregnancies, resulting in 44 live childbirths, in “Panait Sîrbu” Hospital during 2016. A literature review was also conducted examining recent studies devoted to the clinical, therapeutic, and prognostic aspects of HBV infection during pregnancy in order to extrapolate and interpret data that can help physicians in the management of HBV infection in this setting. In our study group, the mean maternal age was 30 (± 7) and the majority were primiparous. Caesarean section was the birth method in 39 (93%) of the cases, with 36 (83.7%) being born at term. In 7 cases (16.2%) spontaneous membrane rupture occurred. All the newborns received active immunoprophylaxis (HBV vaccine) and 38 (88.3%) also received passive immunoprophylaxis consisting in the administration of hepatitis B immune globulin (HBIG). Testing for HBV is recommended in every pregnancy, regardless of previous testing or vaccination. The identification of HBV-positive pregnant women remains the most effective way to prevent HBV transmission to new-borns, combined with passive and active prophylaxis at birth. Breastfeeding is not contraindicated for HBV patients, but it is not recommended for women taking antiviral drugs. Finally, there is no clear evidence that elective caesarean section reduces the risk of mother-tochild transmission compared to vaginal delivery. [ABSTRACT FROM AUTHOR]

Reactivation of hepatitis B virus (HBV) is one of the frequent complications in patients with chronic infection, following cytotoxic or immunosuppressive therapy. We present the case of a 46-year-old male, with a medical history of gastric extranodal marginal zone lymphoma of mucosal-associated lymphoid tissue (MALT lymphoma) and chronic hepatitis B, admitted in the Center of Gastroenterology and Hepatology at the Clinical Institute of Digestive Diseases and Liver Transplantation, in April 2014, accusing asthenia and epigastric pain. It should be noted that the chronic HBV infection had a low replication rate. After performing specific investigations the diagnosis of diffuse large B-cell nonHodgkin lymphoma, stage IV was set. The recommendations were to start the oncologic treatment, accompanied by antiviral prophylaxis to prevent hepatic flares. After six months, the patient presented a complete response to the oncologic treatment, but the decision of continuing with the prophylactic antiviral nucleoside analogue was made. [ABSTRACT FROM AUTHOR]

In the past two decades there have been major developments in the treatment of chronic hepatitis B. The introduction of new antiviral therapies, current knowledge about the natural history of the infection, the contribution of molecular biology to define multiple mutations in the HBV genome have imposed changes in therapeutic strategy lines. Hepatitis B virus (HBV) is a small DNA virus characterized by a high viremia and infectivity The virus is capable of integrating into the cell genome and hepatocellular damage is determined by the host's immune response not by the virus cytopathic effect. It is estimated that over 2 billion people have been exposed to HBV, chronic HBV infection affects more than 350 million people worldwide. Patients with chronic infection have a high risk of progression to cirrhosis and hepatocellular carcinoma (HCC). The goal of antiviral treatment is to prevent disease progression to cirrhosis and/or HCC. In deciding regarding interferon therapy or with nucleoside/nucleotide analogs (NAs), we should examine the relative merits and limitations of each strategy. The main advantage of the interferon therapy is the finite course of treatment and high durability. NAs are administered orally and have fewer side effects. [ABSTRACT FROM AUTHOR]