Infants in the group of treated mothers had a lower HBsAg seropositivity (10/56 vs 23/59 or 18% vs 39%, P = 0.014).34 Unfortunately, Protease Inhibitor Library chemical structure the high rate of lost to follow up or consent withdrawal weakened the conclusions of this important study. Hence, whether giving antivirals to near-term HBV carrier mothers will decrease the perinatal mother-to-infant HBV infection needs to be addressed further with randomized control trials. In dealing with this issue, the cost and safety in both the mothers

and newborns should also be considered. Pregnancy category of the currently available drugs for the treatment of chronic hepatitis B is shown in Table 2. In most instances, the reservation is because of insufficient data in humans to guarantee absence of embryonal adverse effects including teratogenicity. In this regard, the experience in HIV infection is extremely helpful.35 Because humans are the only reservoir of HBV, if HBV can be eradicated, or strongly and

effectively suppressed in the human HBsAg carriers, it will prevent spreading HBV to others, and thus will be an important step toward the elimination and eradication of hepatitis B. The transmission routes of HBV can be classified into horizontal and perinatal (“vertical”) modes (Fig. 2). HBV is highly infectious, because a very tiny amount of body fluids from an HBV carrier can contain a large number of viruses, and infect a susceptible person through mucocutaneous disruptions. Intimate contacts with a virus carrier AZD1208 solubility dmso such as household activities and sharing toys among children can cause the infection. Sexual transmissions are also well-documented. Use of condoms may help to prevent such transmissions. Ear or other body piercings, acupuncture, tattoo or any procedures that disrupt mucocutaneous barriers are

all potentially dangerous. All the instruments that are used in these procedures should be adequately sterilized. Unsafe injections by using unsterilized or inadequately sterilized needles and syringes also result in the spread of HBV.36 This is most serious in illicit injection drug users. Galeterone Whether a needle/syringe exchange program will reduce the risk of HBV infection among the injection drug users remains to be seen.37,38 Insect bites have also been suspected to spread HBV, but the evidence does not seem strong. On the other hand, transfusion of blood or blood products is also an important route of transmission. Despite screening by sensitive serological assays, HBV transmission still occurs in a substantial proportion of susceptible recipients.39 Based on the results of a prospective study in Taiwan from 1987–1994, it was projected that approximately 200 cases of post-transfusion HBV infection could occur for every 1 million units of transfused blood in Taiwan where HBV infection is hyperendemic.