PDF下载 ( 643 KB)
妊娠期妇女和儿童丙型肝炎的管理
DOI: 10.12449/JCH240402
利益冲突声明：本文不存在任何利益冲突。
作者贡献声明：刘奕杉、张兰婷、赵蕴玉负责设计论文框架，起草论文；纪泛扑、曾庆磊负责论文修改，拟定写作思路，指导撰写文章并最后定稿。
-
摘要: HCV感染是全球性的公共卫生问题，直接抗病毒药物的出现为丙型肝炎患者的治疗带来了革命性的突破。尽管直接抗病毒药物在成人患者中的治疗效果显著，但对于孕妇、婴幼儿、青少年这一特殊人群的治疗仍存在诸多挑战。本文旨在探讨这些特殊丙型肝炎人群在抗病毒治疗方面的现状及尚需解决的问题，以期为临床工作者提供参考与借鉴。Abstract: Hepatitis C virus infection is a global public health issue， and the emergence of direct-acting antiviral agents has brought revolutionary breakthroughs in the treatment of hepatitis C patients. Although direct-acting antiviral agents have a marked therapeutic effect in adult patients， there are still many challenges in the treatment of special populations such as pregnant women， infants， young children， and adolescents. This article reviews the current status of antiviral therapy for these special populations with hepatitis C and the problems that need to be solved， in order to provide reference and guidance for clinical workers.
-
Key words:
- Hepatitis C /
- Child /
- Pregnant Women
-
[1] DUGAN E, BLACH S, BIONDI M, et al. Global prevalence of hepatitis C virus in women of childbearing age in 2019: A modelling study[J]. Lancet Gastroenterol Hepatol, 2021, 6( 3): 169- 184. DOI: 10.1016/s2468-1253(20)30359-9. [2] ABBASI F, ALMUKHTAR M, FAZLOLLAHPOUR-NAGHIBI A, et al. Hepatitis C infection seroprevalence in pregnant women worldwide: A systematic review and meta-analysis[J]. EClinicalMedicine, 2023, 66: 102327. DOI: 10.1016/j.eclinm.2023.102327. [3] SALARI N, KAZEMINIA M, HEMATI N, et al. Global prevalence of hepatitis C in general population: A systematic review and meta-analysis[J]. Travel Med Infect Dis, 2022, 46: 102255. DOI: 10.1016/j.tmaid.2022.102255. [4] KUSHNER T, DJERBOUA M, BIONDI MJ, et al. Influence of hepatitis C viral parameters on pregnancy complications and risk of mother-to-child transmission[J]. J Hepatol, 2022, 77( 5): 1256- 1264. DOI: 10.1016/j.jhep.2022.05.016. [5] REDDICK KLB, JHAVERI R, GANDHI M, et al. Pregnancy outcomes associated with viral hepatitis[J]. J Viral Hepat, 2011, 18( 7): e394- e398. DOI: 10.1111/j.1365-2893.2011.01436.x. [6] BENOVA L, MOHAMOUD YA, CALVERT C, et al. Vertical transmission of hepatitis C virus: Systematic review and meta-analysis[J]. Clin Infect Dis, 2014, 59( 6): 765- 773. DOI: 10.1093/cid/ciu447. [7] BHATTACHARYA D, ARONSOHN A, PRICE J, et al. Hepatitis C guidance 2023 update: AASLD-IDSA recommendations for testing, managing, and treating hepatitis C virus infection[J]. Clin Infect Dis, 2023: ciad319. DOI: 10.1093/cid/ciad319. [8] European Association for the Study of the Liver. EASL recommendations on treatment of hepatitis C: Final update of the series[J]. J Hepatol, 2020, 73( 5): 1170- 1218. DOI: 10.1016/j.jhep.2020.08.018. [9] CHAILLON A, RAND EB, REAU N, et al. Cost-effectiveness of universal hepatitis C virus screening of pregnant women in the United States[J]. Clin Infect Dis, 2019, 69( 11): 1888- 1895. DOI: 10.1093/cid/ciz063. [10] THOMPSON LA, PLITT SS, DOUCETTE K, et al. Evaluation and comparison of risk-based and universal prenatal HCV screening programs in Alberta, Canada[J]. J Hepatol, 2023, 79( 5): 1121- 1128. DOI: 10.1016/j.jhep.2023.05.044. [11] ZENG QL, YU ZJ, LV J, et al. Sofosbuvir-based therapy for late pregnant women and infants with severe chronic hepatitis C: A case series study[J]. J Med Virol, 2022, 94( 9): 4548- 4553. DOI: 10.1002/jmv.27877. [12] Chinese Society of Hepatology and Chinese Society of Infectious Diseases, Chinese Medical Association. Guideline for the prevention and treatment of hepatitis C(2022 version)[J]. Chin J Clin Infect Dis, 2022, 15( 6): 428- 447. DOI: 10.3760/cma.j.issn.1674-2397.2022.06.002.中华医学会肝病学分会, 中华医学会感染病学分会. 丙型肝炎防治指南(2022年版)[J]. 中华临床感染病杂志, 2022, 15( 6): 428- 447. DOI: 10.3760/cma.j.issn.1674-2397.2022.06.002. [13] ZENG QL, JI FP. Interpretation of guideline for the prevention and treatment of hepatitis C(2022 version): Antiviral therapy for special populations[J]. J Clin Hepatol, 2023, 39( 7): 1560- 1563. DOI: 10.3969/j.issn.1001-5256.2023.07.008.曾庆磊, 纪泛扑.《丙型肝炎防治指南(2022年版)》解读: 特殊人群抗病毒治疗[J]. 临床肝胆病杂志, 2023, 39( 7): 1560- 1563. DOI: 10.3969/j.issn.1001-5256.2023.07.008. [14] CHAPPELL CA, SCARSI KK, KIRBY BJ, et al. Ledipasvir plus sofosbuvir in pregnant women with hepatitis C virus infection: A phase 1 pharmacokinetic study[J]. Lancet Microbe, 2020, 1( 5): e200- e208. DOI: 10.1016/S2666-5247(20)30062-8. [15] YATTOO GN, SHAFI SM, DAR GA, et al. Safety and efficacy of treatment for chronic hepatitis C during pregnancy: A prospective observational study in Srinagar, India[J]. Clin Liver Dis, 2023, 22( 4): 134- 139. DOI: 10.1097/CLD.0000000000000082. [16] ABDALLAH M, ALBORAIE M, ABDEL-RAZEK W, et al. Pregnancy outcome of anti-HCV direct-acting antivirals: Real-life data from an Egyptian cohort[J]. Liver Int, 2021, 41( 7): 1494- 1497. DOI: 10.1111/liv.14913. [17] YE WH, XU Y. Research progress on vertical transmission mechanism and risk factors of hepatitis C virus from mother to child[J]. Chin J Pediatr, 2018, 56( 6): 477- 479. DOI: 10.3760/cma.j.issn.0578-1310.2018.06.018.叶文辉, 徐翼. 丙型肝炎病毒母婴垂直传播机制及危险因素研究进展[J]. 中华儿科杂志, 2018, 56( 6): 477- 479. DOI: 10.3760/cma.j.issn.0578-1310.2018.06.018. [18] PANAGIOTAKOPOULOS L, SANDUL AL, DHSC, et al. CDC recommendations for hepatitis C testing among perinatally exposed infants and children-United States, 2023[J]. MMWR Recomm Rep, 2023, 72( 4): 1- 21. DOI: 10.15585/mmwr.rr7204a1. [19] ZHU SS, ZENG QL, DONG Y, et al. Interferon-α plus ribavirin yields 98% sustained virologic response in children aged 1-5 years with iatrogenic chronic hepatitis C[J]. Hepatol Int, 2015, 9( 4): 578- 585. DOI: 10.1007/s12072-015-9671-8. [20] HE S, WANG XY, HAN QY, et al. Use of sofosbuvir-based regimens in the treatment of adolescents and children with chronic hepatitis C[J]. Chin J Hepatol, 2021, 29( 1): 83- 86. DOI: 10.3760/cma.j.cn501113-20190606-00199.贺珊, 王小云, 韩群英, 等. 基于索磷布韦的方案在未成年慢性丙型肝炎患者中的应用[J]. 中华肝脏病杂志, 2021, 29( 1): 83- 86. DOI: 10.3760/cma.j.cn501113-20190606-00199. [21] TUCCI F, CALBI V, BARZAGHI F, et al. Successful treatment with ledipasvir/sofosbuvir in an infant with severe combined immunodeficiency caused by adenosine deaminase deficiency with HCV allowed gene therapy with strimvelis[J]. Hepatology, 2018, 68( 6): 2434- 2437. DOI: 10.1002/hep.30160. [22] CONTE D, FRAQUELLI M, PRATI D, et al. Prevalence and clinical course of chronic hepatitis C virus(HCV) infection and rate of HCV vertical transmission in a cohort of 15, 250 pregnant women[J]. Hepatology, 2000, 31( 3): 751- 755. DOI: 10.1002/hep.510310328. [23] SQUIRES JE, BALISTRERI WF. Hepatitis C virus infection in children and adolescents[J]. Hepatol Commun, 2017, 1( 2): 87- 98. DOI: 10.1002/hep4.1028. [24] World Health Organization. Updated recommendations on treatment of adolescents and children with chronic HCV infection, and HCV simplified service delivery and diagnostics[EB/OL].( 2022-06-24). Geneva: World Health Organization, 2022. [25] ROSENTHAL P, SCHWARZ KB, GONZALEZ-PERALTA RP, et al. Sofosbuvir and ribavirin therapy for children aged 3 to<12 years with hepatitis C virus genotype 2 or 3 infection[J]. Hepatology, 2020, 71( 1): 31- 43. DOI: 10.1002/hep.30821. [26] MURRAY KF, BALISTRERI WF, BANSAL S, et al. Safety and efficacy of ledipasvir-sofosbuvir with or without ribavirin for chronic hepatitis C in children ages 6-11[J]. Hepatology, 2018, 68( 6): 2158- 2166. DOI: 10.1002/hep.30123. [27] SCHWARZ KB, ROSENTHAL P, MURRAY KF, et al. Ledipasvir-sofosbuvir for 12 weeks in children 3 to<6 years old with chronic hepatitis C[J]. Hepatology, 2020, 71( 2): 422- 430. DOI: 10.1002/hep.30830. [28] EL-KARAKSY H, MOGAHED EA, ABDULLATIF H, et al. Sustained viral response in genotype 4 chronic hepatitis C virus-infected children and adolescents treated with sofosbuvir/ledipasvir[J]. J Pediatr Gastroenterol Nutr, 2018, 67( 5): 626- 630. DOI: 10.1097/MPG.0000000000002101. [29] JONAS MM, SQUIRES RH, RHEE SM, et al. Pharmacokinetics, safety, and efficacy of glecaprevir/pibrentasvir in adolescents with chronic hepatitis C virus: Part 1 of the DORA study[J]. Hepatology, 2020, 71( 2): 456- 462. DOI: 10.1002/hep.30840. [30] SOKAL EM, SCHWARZ KB, ROSENTHAL P, et al. Safety and efficacy of sofosbuvir/velpatasvir for the treatment of chronic hepatitis C infection in children and adolescents aged 3 to 17 years old through 24 weeks posttreatment[J]. Hepatology, 2020, 72: 570A. [31] EL-SAYED MH, EBEID FSE, ZEKRI AR, et al. Ledipasvir-sofosbuvir in adolescents with chronic hepatitis C and hematological malignancies undergoing chemotherapy[J]. J Pediatr Gastroenterol Nutr, 2022, 74( 5): 626- 630. DOI: 10.1097/MPG.0000000000003406. [32] IMAM U, PARKASH A, DARYANI N, et al. Usefulness of sofosbuvir and daclatasvir combination in the treatment of HCV infection in childhood cancer patients: Experience from A tertiary care hospital[J]. J Pak Med Assoc, 2023, 73( 11): 2183- 2188. DOI: 10.47391/JPMA.8433. [33] MAKHLOUF NA, ABDELMALEK MO, IBRAHIM ME, et al. Ledipasvir/sofosbuvir in adolescents with chronic hepatitis C genotype 4 with and without hematological disorders: Virological efficacy and impact on liver stiffness[J]. J Pediatric Infect Dis Soc, 2021, 10( 1): 7- 13. DOI: 10.1093/jpids/piaa006. -
本文二维码
计量
- 文章访问数: 379
- HTML全文浏览量: 108
- PDF下载量: 127
- 被引次数: 0
下载:
