Hi Everich, I want to add my two cents since I have lived with chronic hepB for 60 years and have so far lived a very healthy and happy life. I’m married with 2 grown children and just recently became a grandmother. So I can reassure you that your wife should expect to live a long and healthy life, too. My best advice for you is to have her see a doctor who is knowledgeable about hepatitis B since she can be evaluated now before giving birth to see if treatment should be started in her last 3 months. Also, after she gives birth to your baby, she will need to monitored regularly to care for the health of her liver longterm.
Finally, I want to give you an action plan based on what Thomas and John wrote above about how best to protect your newborn baby from getting infected with hepB so you completely understand what needs to be done.
(1) Have your wife see a doctor now who can evaluate whether she needs treatment for hepb during her last 3 months (treatment would decrease the amount of virus in her blood).
(2) Tell the doctor who is going to deliver your baby that your wife has hepB and your baby will need the first dose of the hepB vaccine and one dose of HBIG (hepB immunoglobulin) immediately after birth.
(3) Make sure that the doctor or hospital has the first dose of hepB vaccine and one dose of HBIG available the day you arrive so your baby can be given both drugs immediately after being born. Both of these drugs are given by injection.
(4) The BEST is if both the first dose of hepB vaccine and HBIG are given immediately after your baby is born, before they go to the nursery. There is no 2nd chance to protect your baby, and if the hospital delays giving these drugs that would be a big problem.
Although the World Health Organization says there is a 24-hour window to protect your baby from hepB, the United States CDC guidelines say 12 hours, and the Hep B Foundation recommends both the vaccine and HBIG be given in the delivery room for maximum insurance that your baby will be protected from an infection.
This is a very long response, but I’m emphasizing the importance of protecting newborns from hepB immediately. Thanks and best wishes on the birth of your new baby!!! What a wonderful experience … Joan
Hi Everich, if your antibody levels are high enough, there is very very little risk of you getting a chronic HBV infection during intercourse. There are many instances of couples being together for decades and having children without infecting their partners. This has been possible because the vaccine is so effective in preventing transmission.
Your best protection is vaccination because that is extremely effective in blocking transmission via sex. The published efficacy rates for the vaccine are around 95% for generating sufficient antibodies. Transmission when your HBV antibodies (called anti-HBsAg) from the vaccine are >10 IU/ml is extremely rare. Your medical provider can do a simple blood test to measure your anti-HBsAg antibody levels. Using a condom will further reduce the risk. I hope this helps.
Yes I agree with Thomas and John that you should be vaccinated and this will protect you against infection. For planning pregnancy I support Joan’s detailed action plan. The minimum is for your baby to receive HBV vaccine and HBIG (antibody) as soon as possible after birth, which is very effective at preventing infection in the baby. If your wife has very high levels of virus in the blood then I would also recommend antiviral therapy in the third trimester to further reduce the risk. You should see someone with expertise in this to confirm the best approach for you and your wife.
This is definitely something that can be sorted out and should not put you off having children if that is what you want to do.
Good luck!
Sorry to ask again from here… please what can of test I need to do because I myself is negative while my partner is positive with hepatitis B…so please what can of lab test I need to do so I will be sure that I’m fully protected because we really want to have kids asap
To find out if you’re protected, you need to test for your hbsab (hepatitis b virus surface antibody) levels. You are protected if they are above 12 units.
If it is below this, you can get another course of vaccinations that can boost your levels.
Yes I agree with Thomas that the anti-HBsAb is the key test to check whether you are protected.
We always recommend doing HBsAg and anti-HBcAb initially as well, just to be sure that you don’t already have hepatitis B or that you haven’t had it before and cleared it naturally. Interpretation of all these tests can be a bit complicated so best to discuss the tests and results with your doctor to make sure you understand what it all means.
Hello sir
I was advised to do antibody test for hepatitis b because my wife was diagnosed with hepatitis b positive and we planning to have kids…so I was afraid to have kids with my beloved wife and I really don’t wanna leave her because of this illness…I wanna be with her husband till the end of life…
Now here comes my hepatitis b antibody report…
SPECIAL SEROLOGY
Test Name:ANTI HBs ANTIBODY
Chemiluminescent microparticle
immunoassay (CMIA)
Test Result: 104.55 mIU/mL
Now I’m I fully protected from getting hepatitis b? Because I wanna start having kids with my beloved wife.
I am not a physician, so I cannot give medical advice. It is best to ask this question of your care provider.
However, I can tell you some general things: HBsAg antibodies are highly protective against HBV infection. The accepted levels for protection are usually considered to be over 10-12 IU/ml. If I understand the units in the report below properly, you have 0.104 IU/ml. However that interpretation requires that the nomenclature for the units follow the standard SI naming conventions (ie, 1000 mIU = 1 IU), and sometimes medical tests use different naming conventions. Hence my strong recommendation you speak with your care provider.
If you are negative, you can still have a long and happy life, with children, together with your wife! The HBV vaccine is safe and very effective. If your care provider says that the interpretation of the test above is correct (ie, your antibodies are low), then I recommend being vaccinated promptly.
Others on this email chain, like Joan Block, can give you far better advice about sharing your life with a loved one who is HBV+. Many happy couples (and families) are in your situation, and so I’m confident with support from HepB Community, the Hepatitis B Foundation, and your medical providers that you can manage this safely.
I agree with John that you are always best discussing these things with your doctor to get the best advice. The tests that I’m familiar with use 10mIU/mL as a threshold for protection, but he is right that there may be different tests throughout the world that are different. Your local doctor would probably know best.
Thomas is right–I had a memory lapse (or they changed the definition of a unit in the ~25 years since I learned the protection cut-off value). I apologize for giving a mistaken reply that may have alarmed you. By this assay data and cut-off value, you are likely to be protected. However, as always with decisions that affect your health care, it is best to discuss this directly with your care provider.
Hi Everich, I agree with the knowledgeable scientists Thomas Tu and John Tavis that you can plan to enjoy a very happy, healthy and long life with your beloved wife. It does appear that you have surface antibodies that will protect you from infection with the hepatitis B virus. So once you confirm this with your doctor, he or she should be able to reassure that you can definitely plan to have children! Don’t wait … children are wonderful!! I live with chronic hep B and my husband does not, and we have had a very happy marriage for 25 years and our 2 children are healthy and married as well. I hope all of our messages are giving you hope and comfort!! Thanks so much for sharing your situation. Always, Joan
In response to your question, TDF (the precursor to TAF) is regularly used to treat pregnant women as it is much safer than entecavir (which is thought to affect the fetus from some lab studies). TAF is very similar to TDF, but TAF is slightly modified so that you need much less of it to get the same effect - you can use 90% less drug and still inhibit the virus.
Some clinical studies (some of them in HIV-positive mothers; TAF can be used to treat HIV too) have found that TAF has very low adverse effects on pregnant women and is very safe.
Hi Priyanka, I agree with Thomas Tu who is a knowledgeable scientist. But in case you’re still concerned, you could consider switching to tenofovir disproxil during the last 3 months of your pregnancy since there are many studies that confirm it is safe in pregnant women. And then return to TAF after delivery. Just an idea to consider asking your doctor. However, as Thomas wrote, it would most likely be safe to stay on TAF as well. Thanks so much for your questions. Please keep us posted if you’re able! Always, Joan
It surprises me that TDF is safer than TAF. My wife was underweight. When she was on TDF , she developed chronic kidney disease and Osteoporosis. As soon as she switch to TAF, her kidney disease reverses and her Osteoporosis score stop and now improving
Why will a pregnant women change her antiretroviral drug from TAF to TDF then back to TAF, was there a clinical documentation of such procedure for pregnant woman?
