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[乙型肝炎与妊娠]

[Hepatitis B and pregnancy].

作者信息

Arfaoui Dalenda, Fkih Meriem, Hafsa Alaa Eddine, Kaabia Naoufel, Azzouz Msadek

机构信息

Service de gastroentérologie, CHU Sahloul- Sousse, Tunis.

出版信息

Tunis Med. 2010 Jun;88(6):383-9.

Abstract

BACKGROUND

Chronic Hepatitis B infection can lead to liver cirrhosis and hepatocellular carcinoma. In women, these viral infections can be responsible for transmission to the husband and to the child during delivery.

AIM

The purpose of this review is to analyze from the literature the mechanism of mother-to-child transmission and the consequences.

METHODS

We conducted a review of the literature through the interrogation of the MEDLINE database using a query documentary by combining the Boolean (AND) keywords (MeSH) as follows: <>; <>; <>; <>.

RESULTS

Hepatitis B virus transmission by sexual contact in low prevalence areas and infection occurs during either the perinatal period or early in childhood in moderate or high prevalence areas. In Tunisia, the prevalence of Antigen HBS (HBs Ag) with pregnant women is 3 to 4%. The risk of maternal-infant contamination is high, from 20 to 90 per cent according to the viral load in the mother. Mother-to-child transmission can be avoided by serovaccination of the newborn.The women with very high viral loads may receive lamivudine treatment at the end of pregnancy to diminish viral load and thus the risk of chronic carriage in the child; however the role of this drug in this situation is not yet clearly defined.

摘要

背景

慢性乙型肝炎感染可导致肝硬化和肝细胞癌。在女性中,这些病毒感染可导致在分娩期间将病毒传播给丈夫和孩子。

目的

本综述的目的是从文献中分析母婴传播的机制及其后果。

方法

我们通过使用布尔(AND)关键词(医学主题词)组合查询文档来检索MEDLINE数据库,从而对文献进行综述,具体如下:<<乙型肝炎>>;<<垂直传播>>;<<妊娠>>;<<分娩>>。

结果

在低流行地区,乙型肝炎病毒通过性接触传播,而在中度或高度流行地区,感染发生在围产期或儿童早期。在突尼斯,孕妇中乙肝表面抗原(HBs Ag)的流行率为3%至4%。母婴感染的风险很高,根据母亲的病毒载量,感染风险为20%至90%。通过给新生儿接种血清疫苗可以避免母婴传播。病毒载量非常高的女性在妊娠末期可接受拉米夫定治疗,以降低病毒载量,从而降低孩子慢性携带病毒的风险;然而,这种药物在这种情况下的作用尚未明确界定。

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