预防HBV母婴传播中值得注意的几个问题

摘要/Abstract

摘要： 母婴传播是HBV的主要传播途径,特别是高地方性流行地区。婴儿出生时注射乙型肝炎免疫球蛋白和乙型肝炎疫苗,并随后完成全程接种,可预防约95% HBsAg阳性母亲将HBV传播给其婴儿,但仍可有5%~10%高水平病毒血症母亲的婴儿为免疫预防失败。现已证明,在孕晚期给予高病毒载量孕妇核苷和核苷酸类药物抗病毒治疗,可进一步降低HBV母婴传播。本文讨论了抗病毒治疗预防母婴传播的标准,包括孕妇HBV DNA的阈值、开始治疗时间、停药时间、用药种类,以及乙型肝炎疫苗的接种途径等值得注意的几个问题。

关键词: 肝炎病毒,乙型, 母婴传播, 免疫球蛋白类, 肝炎疫苗,乙型

Abstract: Mother-to-child transmission (MTCT) is the major route of transmission of hepatitis B virus (HBV), especially areas withhigh prevalence rates. Injection of hepatitis B immunoglobulin (HBIG) and hepatitis B vaccine for infants at birth, followed by completevaccination, can prevent HBV transmission to infants in 95% of HBsAg-positive mothers. However, immunoprophylaxis failure is still observed in 5%~10% infants born to mothers with high-level viremia. It has been demonstrated that nucleos(t) ide analogues for pregnant women with a high viral load in late pregnancy as antiviral therapy can further reduce MTCT of HBV. This article discusses the criteria of antiviral therapy for the prevention of MTCT, including the threshold of HBV DNA level in pregnant women, time of the start of treatment, time of drug withdrawal, type of drugs, and inoculation route of hepatitis B vaccine.

Key words: Hepatitis B virus, Mother-to-child transmission, Immunoglobulins, Hepatitis B vaccines

中华肝脏病杂志临床肝胆病杂志《肝脏》杂志联合社评. 预防HBV母婴传播中值得注意的几个问题[J]. 肝脏, 2016, 21(12): 1013-1015.

Chinese Journal of Hepatology, Journal of Clinical Hepatology, and Chinese Hepatology. Several issues regarding prevention of mother-to-child transmission of hepatitis B virus[J]. Chinese Hepatolgy, 2016, 21(12): 1013-1015.

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