Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, China.
BMC Infect Dis. 2012 Sep 17;12:221. doi: 10.1186/1471-2334-12-221.
Hepatitis B virus (HBV) infection is endemic in China; perinatal transmission is the main source of chronic HBV infection. Simultaneous administration of hepatitis B immune globulin (HBIG) and hepatitis B vaccine is highly effective to prevent perinatal transmission of HBV; however, the effectiveness also depends on full adherence to the recommended protocols in daily practice. In the present investigation, we aimed to identify gaps in immunoprophylaxis of perinatal transmission of HBV between recommendations and routine practices in Jiangsu Province, China.
Totally 626 children from 6 cities and 8 rural areas across Jiangsu Province, China, born from February 2003 to December 2004, were enrolled; 298 were born to mothers with positive hepatitis B surface antigen (HBsAg) and 328 were born to HBsAg-negative mothers. Immunoprophylactic measures against hepatitis B were retrospectively reviewed for about half of the children by checking medical records or vaccination cards and the vaccine status was validated for most of children.
Of 298 children born to HBV carrier mothers, 11 (3.7%) were HBsAg positive, while none of 328 children born to non-carrier mothers was HBsAg positive (P < 0.01). The rates of anti-HBs ≥ 10 mIU/ml in children of carrier and non-carrier mothers were 69.5% and 69.2% respectively (P = 0.95). The hepatitis B vaccine coverage in two groups was 100% and 99.4% respectively (P = 0.50), but 15.1% of HBV-exposed infants did not receive the timely birth dose. Prenatal HBsAg screening was performed only in 156 (52.3%) of the carrier mothers. Consequently, only 112 (37.6%) of HBV-exposed infants received HBIG after birth. Furthermore, of the 11 HBV-infected children, only one received both HBIG and hepatitis B vaccine timely, seven missed HBIG, two received delayed vaccination, and one missed HBIG and received delayed vaccination.
There are substantial gaps in the prevention of perinatal HBV infection between the recommendations and routine practices in China, which highlights the importance of full adherence to the recommendations to eliminate perinatal HBV infection in the endemic regions.
乙型肝炎病毒 (HBV) 感染在中国流行；母婴传播是慢性 HBV 感染的主要来源。同时接种乙型肝炎免疫球蛋白 (HBIG) 和乙型肝炎疫苗对预防母婴传播 HBV 非常有效；然而，其有效性也取决于在日常实践中是否完全遵守推荐方案。在本研究中，我们旨在确定江苏省推荐方案与常规实践之间在预防母婴传播 HBV 方面存在的差距。
共纳入江苏省 6 个城市和 8 个农村地区于 2003 年 2 月至 2004 年 12 月间出生的 626 名儿童；其中 298 名儿童的母亲 HBsAg 阳性，328 名儿童的母亲 HBsAg 阴性。通过查阅病历或接种卡，对其中一半儿童的乙型肝炎免疫预防措施进行回顾性审查，并对大多数儿童的疫苗接种情况进行了验证。
在 298 名 HBV 携带母亲所生的儿童中，有 11 名（3.7%）HBsAg 阳性，而在 328 名非携带母亲所生的儿童中无 1 名 HBsAg 阳性（P < 0.01）。携带母亲和非携带母亲的儿童抗-HBs≥10 mIU/ml 的比例分别为 69.5%和 69.2%（P = 0.95）。两组乙型肝炎疫苗接种率分别为 100%和 99.4%（P = 0.50），但有 15.1%的 HBV 暴露婴儿未及时接种首针。仅对 156 名（52.3%）携带母亲进行了产前 HBsAg 筛查。因此，仅 112 名（37.6%）HBV 暴露婴儿在出生后接受了 HBIG。此外，在 11 名 HBV 感染儿童中，仅有 1 名儿童及时接受了 HBIG 和乙型肝炎疫苗接种，7 名儿童漏种 HBIG，2 名儿童接种延迟，1 名儿童漏种 HBIG 且接种延迟。
中国在预防母婴传播 HBV 方面，推荐方案与常规实践之间存在较大差距，这突显了全面遵循推荐方案以消除流行地区母婴传播 HBV 的重要性。
