Consensus on the management of hepatitis B virus infection in women of childbearing age
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摘要:
<正>HBV母婴传播是导致慢性HBV感染的主要原因,即HBV阳性孕妇在妊娠期或分娩过程中将HBV传染给新生儿。如果对HBV阳性母亲所生新生儿不采取任何免疫预防措施,70%~90%的新生儿会感染HBV,而新生儿一旦感染,90%以上会发展为慢性HBV感染[1-2]。自1992年我国开始将乙型肝炎疫苗(hepatitis B vaccine,HepB)纳入免疫规划管理,特别是自2002年HepB免费和2005年新生儿HepB接种完全免费以来,我国儿童和一般人群HBV感染率明显下降[3]。2014年全国血清流行病学调查显
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Key words:
- hepatitis B virus /
- women of childbearing age /
- mother-to-child transmission /
- consensus
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[1] Chinese Society of Hepatology and Chinese Society of Infectious Diseases, Chinese Medical Association.The guideline of prevention and treatment for chronic hepatitis B:A 2015 update[J].J Clin Hepatol, 2015, 31 (12) :1941-1960. (in Chinese) 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 (2015年更新版) [J].临床肝胆病杂志, 2015, 31 (12) :1941-1960. [2] National Health and Family Planning Commission of the People's Republic of China.Implementation plan for prevention of mother to child transmission of AIDS, syphilis and hepatitis B (2015 version) [EB/OL]. (2015-06-16) [2018-02-12].http://www.nhfpc.gov.cn/ewebeditor/uploadfile/2015/06/20150615151817186.docx. (in Chinese) 国家卫生和计划生育委员会.预防艾滋病、梅毒和乙肝母婴传播工作实施方案 (2015年版) [EB/OL]. (2015-06-16) [2018-02-12].http://www.nhfpc.gov.cn/ewebeditor/uploadfile/2015/06/20150615151817186.docx. [3]PAN CQ, DUAN ZP, BHAMIDIMARRI KR, et al.An algorithm for risk assessment and intervention of mother to child transmission of hepatitis B virus[J].Clin Gastroenterol Hepatol, 2012, 10 (5) :452-459. [4]KANG W, LI QF, SHEN LP, et al.Risk factors related to the failure of prevention of hepatitis B virus mother-to-child transmission in Yunnan, China[J].Vaccine, 2017, 35 (4) :605-609. [5]MACHAIRA M, PAPAEVANGELOU V, VOULOUMANOU EK, et al.Hepatitis B vaccine alone or with hepatitis B immunoglobulin in neonates of HBs Ag+/HBe Ag-mothers:A systematic review and metaanalysis[J].J Antimicrob Chemother, 2015, 70 (2) :396-404. [6]CHEN HL, WEN WH, CHANG MH.Management of pregnant women and children:Focusing on preventing mother-to-infant transmission[J].J Infect Dis, 2017, 216 (Suppl 8) :s785-s791. [7]ZHENG H, CUI FQ, WANG FZ, et al.The epidemiology of hepatitis B virus infection in women of reproductive age in highly endemic areas in China[J].J Viral Hepat, 2018, 25 (1) :88-96. [8]DING Y, SHENG QJ, MA L, et al.Chronic HBV infection among pregnant women and their infants in Shenyang, China[J].Virol J, 2013, 10:17. [9]Chinese Foundation for Hepatitis Prevention and Control;Chinese Society of Infectious Diseases, Chinese Medical Association;Chinese Society of Hepatology, Chinese Medical Association.Management algorithm for interrupting mother-to-child transmission of hepatitis B[J].J Clin Hepatol, 2017, 33 (7) :1214-1217. (in Chinese) 中国肝炎防治基金会, 中华医学会感染病学分会, 中华医学会肝病学分会.乙型肝炎母婴阻断临床管理流程[J].临床肝胆病杂志, 2017, 33 (7) :1214-1217. [10]DOU XG.Strategy for anti-HBV therapy in women of childbearing age and pregnancy[J].Chin J Hepatol, 2015, 23 (11) :801-802. (in Chinese) 窦晓光.育龄期妇女及孕妇抗乙型肝炎病毒治疗策略[J].中华肝脏病杂志, 2015, 23 (11) :801-802. [11]Society for Maternal-Fetal Medicine (SMFM) , DIONNE-ODOM J, TITA AT, et al.Hepatitis B in pregnancy screening, treatment, and prevention of vertical transmission[J].Am J Obstet Gynecol, 2016, 214 (1) :6-14. [12]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. [13]HAN GR, CAO MK, ZHAO W, 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].J Hepatol, 2011, 55 (6) :1215-1221. [14]HAN GR, JIANG HX, YUE X, et al.Efficacy and safety of telbivudine treatment:an open-label, prospective study in pregnant women for the prevention of perinatal transmission of hepatitis B virus infection[J].J Viral Hepat, 2015, 22 (9) :754-762. [15]ZHANG H, PAN CQ, PANG Q, et al.Telbivudine or lamivudine use in late pregnancy safely reduces perinatal transmission of hepatitis B virus in real-life practice[J].Hepatology, 2014, 60 (2) :468-476. [16]SHENG QJ, DING Y, LI BJ, et al.Telbivudine for prevention of perinatal transmission in pregnant women infected with hepatitis B virus in immune-tolerant phase:A study of efficacy and safety of drug withdrawal[J].Chin J Hepatol, 2016, 24 (4) :258-264. (in Chinese) 盛秋菊, 丁洋, 李佰君, 等.HBV感染免疫耐受期孕妇应用替比夫定阻断母婴传播有效性及停药安全性的研究[J].中华肝脏病杂志, 2016, 24 (4) :258-264. [17]GREENUP AJ, TAN PK, NGUYEN V, et al.Efficacy and safety of tenofovir disoproxil fumarate in pregnancy to prevent perinatal transmission of hepatitis B virus[J].J Hepatol, 2014, 61 (3) :502-507. [18]CHEN HL, LEE CN, CHANG CH, et al.Efficacy of maternal tenofovir disoproxil fumarate in interrupting mother-to-infant transmission of hepatitis B virus[J].Hepatology, 2015, 62 (2) :375-386. [19]GREENUP AJ, TAN PK, NGUYEN V, et al.Efficacy and safety of tenofovir disoproxil fumarate (TDF) in pregnancy to prevent perinatal transmission of hepatitis B virus[J].J Hepatol, 2015, 63 (4) :1054-1061. [20]PAN CQ, DUAN Z, DAI E, et al.Tenofovir to prevent hepatitis B transmission in mothers with high viral load[J].N Engl J Med, 2016, 374 (24) :2324-2334. [21]TERRAULT NA, BZOWEJ NH, CHANG KM, et al.AASLD guidelines for treatment of chronic hepatitis B[J].Hepatology, 2016, 63 (1) :261-283. [22]European Association for the Study of the Liver.EASL 2017 Clinical Practice Guidelines on the management of hepatitis B virus infection[J].J Hepatol, 2017, 67 (2) :370-398. [23]GILES M, VISVANATHAN K, LEWIN S, et al.Clinical and virological predictors of hepatic flares in pregnant women with chronic hepatitis B[J].Gut, 2015, 64 (11) :1810-1815. [24]CHANG CY, AZIZ N, POONGKUNRAN M, et al.Serum alanine aminotransferase and hepatitis B DNA flares in pregnant and postpartum women with chronic hepatitis B[J].Am J Gastroenterol, 2016, 111 (10) :1410-1415. [25]SHI Z, YANG Y, WANG H, et al.Breastfeeding of newborns by mothers carrying hepatitis B virus:A meta-analysis and systematic review[J].Arch Pediatr Adolesc Med, 2011, 165 (9) :837-846. [26]EHRHARDT S, XIE C, GUO N, et al.Breastfeeding while taking lamivudine or tenofovir disoproxil fumarate:A review of the evidence[J].Clin Infect Dis, 2015, 60 (2) :275-278. [27]ZOU H, CHEN Y, DUAN Z, et al.Virologic factors associated with failure to passive-active immunoprophylaxis in infants born to HBs Ag-positive mothers[J].J Viral Hepat, 2012, 19 (2) :e18-e25.
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