Course Summary

Pregnant patients diagnosed with chronic hepatitis B virus or hepatitis C virus have been associated with viral transmission from mother-to-child and significant maternal and fetal complications. There have been several large population based studies that reviewed corresponding risk factors, such as ethnicity, social variables, and lifestyle risks, related to prevalence rates and treatment outcomes for a viral hepatitis infection. Hepatitis infection and chronic disease is associated with adverse pregnancy outcomes and poor infant health. Infants born to mothers with highly infectious viral hepatitis disease continue to carry a significant health concern without antiviral prophylactic treatment. Chronic viral hepatitis in pregnant and pediatric patients requires routine medical follow-ups, monitoring and treatment.

Course Format

Homestudy

Course Syllabus

• I.   Introduction
• II.  Epidemiology
  • 1. Hepatitis B
  • 2. Hepatitis C
• III. Transmission of Hepatitis B and C
  • 1. Risk of Mother-Child Transmission
  • 2. Breastfeeding
  • 3. Hepatitis B and C Infection
•  IV. Health During Pregnancy: Hepatitis B and C
  • 1. Pregnancy Outcomes
•   V. Treatment During Pregnancy
  • 1. Indications for Antiviral Treatment
  • 2. Initiation of Antiviral Therapy
  • 3. Tenofovir disoproxil fumarate
  • 4. Postpartum Flares of Hepatitis B
  • 5. Pregnancy and Antivirals
•  VI. Treatment of the Newborn
  • 1.   Screening
  • 2.   Breastfeeding
  • 3.   Maternal Screening for Hepatitis B and C
• VII.  Case Study: Hepatitis C and Mother-Infant Vertical Transmission
• VIII. Summary

Authors

Marilyn Lajoie, MD, DC, CCSP

Dr. Marilyn Lajoie obtained her medical degree from Saba University School of Medicine in 1999, Her residency began with one year of Anatomical and Surgical Pathology at Orlando Regional Medical Center, before transferring within the same post-graduate residency program to Internal Medicine. Upon completion of residency, she went into private practice in Orlando, where she specialized in Internal Medicine, Sports Medicine and Rehab, as well as acute and chronic pain management. Before becoming a medical doctor, she had practiced as a Chiropractic Physician, graduating from New York Chiropractic College in 1980, practicing initially on Long Island, N.Y., before moving to Florida where she had a successful chiropractic practice and physical rehabilitation center, and gained recognition as a Certified Chiropractic Sports Physician. Dr. Lajoie was also the Director of Physical Therapy at Horizon Hospital, a residential and outpatient psychiatric hospital, and later, continued in the same capacity at Horizon’s sister psychiatric hospital in Brooksville, Florida. Dr. Lajoie maintained her chiropractic license and continued to practice both Internal Medicine and Chiropractic throughout private practice, until moving to the Veterans Healthcare System in 2014. Continuing in both fields, she became the Deputy Chief of Staff for the Montana VA, where she completed her service in 2021. Dr. Lajoie now works predominantly in telemedicine, and in an Expert Witness capacity for both medical and chiropractic cases. Still living in Montana, she enjoys being able to treat not only the rural areas of the state through this technology, but also patients across the US where she maintains multiple active state licenses. She and her husband also own a llama ranch with over thirty llamas that are hand selected for rare genetics. At the llama ranch, the public is invited to come and visit to learn about these elegant creatures, and to see ranch life firsthand – llama style! Dr. Lajoie and her husband have six adult children, as well as seven dogs.