Department of Obstetrics and Gynecology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Rev Med Virol. 2014 Nov;24(6):396-406. doi: 10.1002/rmv.1801. Epub 2014 Jun 23.
Mother-to-child transmission (MTCT) of HBV is responsible for approximately half of the HBV transmission routes and continues to be a challenging problem worldwide. Even after the development of effective vaccines and clear World Health Organization guidelines toward HBV several decades ago, 1-9% newborns of HBV-carrying mothers still acquire HBV in early life as a result of in utero infection. The prevention of MTCT is of high importance, because chronically infected individuals function as a reserve for sustained HBV transmission, and 25% of them can develop asymptomatic liver cirrhosis and hepatocellular carcinoma. In this article, we review the canonical and novel HBV infection routes/mechanisms, influencing factors, diagnostic criteria, and interruption strategies for HBV MTCT. The preventative strategy of HBV MTCT has evolved from routine postpartum HB immune globulin (HBIG) plus HB vaccine schedules to administration of HBIG or nucleoside analogs during pregnancy and minimizing the exposure of maternal body fluids to the newborn during delivery.
母婴传播（MTCT）是 HBV 传播的主要途径之一，占 HBV 传播途径的一半左右，这仍然是全世界面临的一个挑战。尽管几十年前就已经开发出了有效的疫苗和明确的世界卫生组织（WHO）HBV 防治指南，但仍有 1%-9%的 HBV 携带母亲的新生儿在生命早期因宫内感染而获得 HBV。预防 MTCT 非常重要，因为慢性感染的个体是 HBV 持续传播的储备宿主，其中 25%的个体可能会发展为无症状性肝硬化和肝细胞癌。本文回顾了 HBV 感染的经典和新型途径/机制、影响因素、诊断标准和 HBV MTCT 的阻断策略。HBV MTCT 的预防策略已经从常规的产后乙型肝炎免疫球蛋白（HBIG）加乙型肝炎疫苗方案演变为在妊娠期间使用 HBIG 或核苷类似物，并在分娩过程中尽量减少母体体液对新生儿的暴露。
