[1]蒲杰,孙玲玲 综述,刘兴会* 审校.产前预防乙型肝炎病毒母婴传播现状与进展[J].中国计划生育和妇产科,2019,(9):10-14.
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产前预防乙型肝炎病毒母婴传播现状与进展
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《中国计划生育和妇产科》[ISSN:1674-4020/CN:51-1708/R]

卷:
期数:
2019年9期
页码:
10-14
栏目:
综述
出版日期:
2019-09-25

文章信息/Info

作者:
蒲杰1孙玲玲1 综述刘兴会2* 审校
四川省妇幼保健院·四川省妇女儿童医院
关键词:
乙型肝炎病毒乙型肝炎母婴传播
分类号:
R 714.251
摘要:
乙型肝炎病毒 (hepatitis B virus, HBV) 感染及母婴传播(mother to child transmission, MTCT)对母婴危害严重,应在孕前与孕期进行规范咨询与干预处理。有生育需求的HBV感染妇女,若有抗病毒治疗适应证,应积极抗病毒治疗且停药后6个月以上、肝功能正常、病情稳定后再考虑妊娠,抗病毒治疗期间必须避孕。妊娠期间需定期监测HBV DNA及肝脏B超检查,若肝功明显异常,需咨询肝病专科医师,必要时住院治疗,严重时需终止妊娠。对于高病毒载量的孕妇可在知情同意的情况下考虑第28周左右开始抗病毒治疗, 建议产后1~3 个月停药,停药后可以母乳喂养。在孕晚期不必应用乙肝免疫球蛋白(hepatitis B immunoglobulin,HBIG)来预防MTCT。对需要进行产前诊断的乙型肝炎病毒表面抗原(hepatitis B surface antigen,HBsAg)阳性孕妇应优先采用无创产前筛查技术,并告知高病毒载量羊水穿刺时 HBV 宫内传播的风险可能增加。

参考文献/References:

[1]乙型肝炎病毒感染女性生育管理专家委员会.乙型肝炎病毒感染女性生育管理专家共识 [J].中华实验和临床感染病杂志(电子版),2014,8(1):104-107. [2]OTT J J, STEVENS G A, WIERSMA S T. The risk of perinatal hepatitis B virus transmission: hepatitis B e antigen (HBeAg) prevalence estimates for all world regions [J]. BMC Infectious Diseases, 2012, 12 (1): 131. [3]蒲杰.预防艾滋病、梅毒和乙肝母婴传播技术与进展 [M].成都:四川科技出版社,2015:84-89. [4]PARK J S, PAN C. Current recommendations of managing HBV infection in preconception or pregnancy [J]. Frontiers of Medicine, 2014, 8 (2): 158-165. [5]中华医学会妇产科学分会产科学组.乙型肝炎病毒母婴传播预防临床指南(第1版) [J].中华围产医学杂志,2015,18(5):321-325. [6]Dionne-Odom J, Tita AT, Silverman NS. Society for Maternal-Fetal Medicine (SMFM) Consult Series 38: Hepatitis B in Pregnancy- Screening, Treatment and Prevention of Vertical Transmission [J]. Am J Obstet Gynecol, 2016,214(1):6-4. [7]ZOU H, CHEN Y, DUAN Z, et al. Virologic factors associated with failure to passive-active immunoprophylaxis in infants born to HBsAg-positive mothers [J]. Journal of Viral Hepatitis, 2012, 19 (2): e 18-e 25. [8]YIN Y, STEVENS G A, GROEGER J, et al. Immunoprophylaxis of hepatitis B virus infection and its sequelae [J]. The Journal of Infection, 2013, 66 (5): 447-452. [9]HAN G R, CAO Min-kai, ZHAO Wei, et al. A prospective and open-label study for the efficacy and safety of telbivudine in pregnancy for the prevention of perinatal transmission of hepatitis B virus infection [J]. Journal of Hepatology, 2011, 55 (6): 1215-1221. [10]慢性乙型肝炎特殊患者抗病毒治疗专家委员会.慢性乙型肝炎特殊患者抗病毒治疗专家共识:2015年更新 [J].中国肝脏病杂志(电子版),2015,7(1):115-122. [11]中华医学会肝病学分会.中华医学会感染病学分会.慢性乙型肝炎防治指南 [J].中国肝脏病杂志(电子版),2015,7(3):1-18. [12]TRAN T. Hepatitis B:treatment to prevent perinatal transmission [J]. Clinical Obs Gyn, 2012, 55 (2): 541–549. [13]DIONNE-ODOM J, TITA A T, SILVERMAN N S, et al. Hepatitis B in pregnancy screening, treatment, and prevention of vertical transmission [J]. American Journal of Obstetrics and Gynecology, 2016, 214 (1): 6-14. [14]VISVANATHAN K, DUSHEIKO G, GILES M, et al. Managing HBV in pregnancy. Prevention, prophylaxis, treatment and follow-up: position paper produced by Australian, UK and New Zealand key opinion leaders [J]. Gut, 2016, 65 (2): 340-350. [15]YU Min-min, JIANG Qian, JI Ying, et al. Comparison of telbivudine versus lamivudine in interrupting perinatal transmission of hepatitis B virus [J]. Journal of Clinical Virology : the Official Publication of the Pan American Society for Clinical Virology, 2014, 61 (1): 55-60. [16]LOK A S, MCMAHON B J, BROWN J, et al. Antiviral therapy for chronic hepatitis B viral infection in adults: A systematic review and meta-analysis [J]. Hepatology, 2016, 63 (1): 284-306. [17]SARIN S K, KUMAR M, LAU G K, et al. Asian-Pacific clinical practice guidelines on the management of hepatitis B: a 2015 update [J]. Hepatology International, 2016, 10 (1): 1-98. [18]European Association For The Study Of The Liver. EASL clinical practice guidellines:management of chronic hepatitis B [J]. Journal of Hepatology, 2012, 57 (1): 167-185. [19]TERRAULT N A, BZOWEJ N H, CHANG K M, et al. AASLD guidelines for treatment of chronic hepatitis B [J]. Hepatology (Baltimore, Md.), 2016, 63 (1): 261-283.

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备注/Memo

备注/Memo:
四川省科技厅科技支撑项目(项目编号:2014SZ0114)
更新日期/Last Update: 2019-09-25