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I really need some advice
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I really need some advice

Dear sir,
      I'm from China, I'm 30 years' old. I'v got married, my wife has Hepatitis B.She is Three positive, and DNA is ok,Liver function is also ok. she got Hepatitis B from her mother.   She is now pregnent. I got the Nursery in my childhood.  my question is:
      1, do I have risk to infect if I have sex with her without protection?
      2, Is it ok for her to Breast-feeding our child?
      3, what should I do to pretect our child from Hepatitis B before and after it born?
thank and best regards
Philippe
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1191262_tn?1366766621
What do you mean by three positive? Is she carrying a chronic infection?
1. Yes there is a risk of infection without protection, you need to absolutely use protection and get vaccination if you are not already. It takes 3 doses and 7 months total to take effect. So start now!

2.Yes it is safe to breasted,

3. In the first 24hours after birth, your baby needs to get a vaccine + immune globulin. Also, during your wife's pregnancy, she should consult with a doctor to see if she could benefit from an anti viral treatment to prevent virus transmission. The anti viral is supposed to make her HBV DNA undetectable or close to that so that chances to transmit the virus get very low. Consult with a good hepathologist or gastroenterologist.
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14 Comments Post a Comment
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1191262_tn?1366766621
What do you mean by three positive? Is she carrying a chronic infection?
1. Yes there is a risk of infection without protection, you need to absolutely use protection and get vaccination if you are not already. It takes 3 doses and 7 months total to take effect. So start now!

2.Yes it is safe to breasted,

3. In the first 24hours after birth, your baby needs to get a vaccine + immune globulin. Also, during your wife's pregnancy, she should consult with a doctor to see if she could benefit from an anti viral treatment to prevent virus transmission. The anti viral is supposed to make her HBV DNA undetectable or close to that so that chances to transmit the virus get very low. Consult with a good hepathologist or gastroenterologist.
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Since you already had unprotected sex, before getting any vaccine you should get tested first for hepatitis b, if you are already infected ( I hope not) then vaccine won't help...Get tested first. If you need  more info about pregnancy and breastfeeding, I went through the same experience, you can message me, also check the forum thread called 'Pregnancy and breastfeeding while on Tenofovir (Viread)'.
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Avatar_m_tn
People from China get tested more often than everyone - they are tested when they go to school, go to university, applying for a job and then annually when they are employed.
Big three means: HBsAg+ve, HBeAg+ve, anti-HBcAg +ve.
Small three: HBsAg+ve, anti-HBcAg+ve.

Hope I got it right.
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Avatar_m_tn
yes stephen is right , My wife has small three, I'v got  vaccination in my teenage. I got test about 3 years ago and at that time I still had antibody. WHO had said the  vaccination will protect people at list 20years.  what I want to know is whether I'm safe to have sex with my wife without protection. To have a child need unprotect sex as you know. :)
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Oh I see, good to know that China is taking HBV seriously, I had no idea about the Big and small three :)
Philippe567, The most recent studies say that HBV vaccine provides indefinite protection not only 15 or 20 years, especially if the initial shot worked adequately and whether your HBsAb counts decreases or not over time.
Some other studies say that it is protective for at least 25 years.
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Avatar_m_tn
so it means I'm safe?
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1191262_tn?1366766621
Yes you are safe according to the latest studies. If you d like you could get tested again for antibodies and immunity, just for yourself to feel better.
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Avatar_m_tn
thanks you very much
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1191262_tn?1366766621
HBsAg antibodies count should be > 10mUi/ml.
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Avatar_m_tn
"HBsAg antibodies count should be > 10mUi/ml. "

I second that good advice by enolia. If your HbsAg antibodies count is below 10 iu/ml, which I don't think so, you can get vaccinated again.
Also, HBeAg-ve patients are considered to be not very infectious.
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Just to be certain, the unit is really mUI/ml, so an immune protected state has to show a value higher or equal to 10mUI/ml or equal or higher than 10 UI/l.
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Avatar_m_tn
thanks Stephen and enolia, you are so kind.
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Avatar_m_tn
My apology for the typo. Of course it is 10 mIU/mL  as you stated.

Response to Vaccine

A full series of vaccine is desirable, although 32 to 56% of persons achieve protective levels of anti-hepatitis B surface antibody (HBsAb) with a single dose of vaccine, a percentage that rises to 70 to 75% with two doses. A third dose generates a protective response in more than 90% of healthy vaccinees and provides long lasting protection[8,9]. Certain conditions are associated with decreased response to vaccine including age greater than 40 years, male sex, genetic factors, obesity, tobacco smoking, alcoholism, renal disease, HIV infection, and other immune compromising conditions[6,10,11,12,13,14,15,16,17]. After completion of a vaccine series, a HBsAb level >=10 mIU/mL is considered protective. In general, protection generated by a complete vaccine series is believed to last for at least 15 to 20 years in healthy individuals. Immunity in healthy adults and children appears to persist even though antibody levels may decline over time to low levels, even below detectable limits[18,19,20,21,22,23].
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No worries. Thanks Stephen :)
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