预防HBV母婴传播中值得注意的几个问题

发布时间：2018-01-03 09:35

本文关键词：预防HBV母婴传播中值得注意的几个问题　出处：《临床肝胆病杂志》2016年12期 　论文类型：期刊论文

【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HBVDNA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。
[Abstract]:Mother-to-child transmission is the main route of transmission of HBV, especially in highly endemic areas. Infants are injected with hepatitis B immunoglobulin and hepatitis B vaccine at birth, and then complete the whole process of vaccination. It can prevent the transmission of HBV to their infants by about 95% of the mothers with HBsAg positive, but it can still be proved that 5% of the infants of mothers with high level of viremia can fail in immunological prophylaxis. In the third trimester of pregnancy, the antiviral therapy of high viral load pregnant women with nucleoside and nucleotide drugs can further reduce HBV mother-to-child transmission. This article discusses the standard of antiviral therapy to prevent mother-to-child transmission. These include the threshold of HBVDNA for pregnant women, the time to start treatment, the time of withdrawal, the type of medication, and the route of hepatitis B vaccine.
【作者单位】：中华肝脏病杂志;临床肝胆病杂志;《肝脏》杂志;
【分类号】：R512.62;R183
【正文快照】： HBs Ag阳性母亲的新生儿,出生后接受乙型肝炎免疫球蛋白(HBIG)和乙型肝炎疫苗联合免疫,HBV母婴传播阻断失败率为5%~10%[1-2]。在这些阻断失败的婴儿中,绝大多数是由于其母亲分娩时血清HBV DNA水平高。因此,各国乙型肝炎防治指南或共识均[3-9]建议,对血清HBV DNA水平高的孕妇,

【相似文献】