Evans Alison A, Cohen Chari, Huang Peixin, Qian Liping, London W Thomas, Block Joan M, Chen Gang
Drexel University, Philadelphia, PA, USA; Hepatitis B Foundation, 3805 Old Easton Road, Doylestown, PA 18902, USA.
Hepatitis B Foundation, 3805 Old Easton Road, Doylestown, PA 18902, USA.
Vaccine. 2015 Jun 12;33(26):3010-5. doi: 10.1016/j.vaccine.2015.01.054. Epub 2015 Feb 16.
In regions where hepatitis B virus (HBV) is endemic, perinatal transmission is common. Infected newborns have a 90% chance of developing chronic HBV infection, and 1 in 4 will die prematurely from HBV-related liver disease. In 2010, the Hepatitis B Foundation and the Haimen City CDC launched the Gateway to Care campaign in Haimen City, China to improve awareness, prevention, and control of HBV infection citywide. The campaign included efforts to prevent perinatal HBV transmission by screening all pregnant women for hepatitis B surface antigen (HBsAg), following those who tested positive, and administering immunoprophylaxis to their newborns at birth. Of 5407 pregnant women screened, 185 were confirmed HBsAg-positive and followed until delivery. At age one, 175 babies were available for follow up testing. Of those, 137 tested negative for HBsAg and positive for antibodies to HBsAg, indicating protection. An additional 34 HBsAg-negative babies also tested negative for antibodies to HBsAg or had indeterminate test results, were considered to have had inadequate immune responses to the vaccine, and were given a booster dose. A higher prevalence of nonresponse to HBV vaccine was observed among babies born to hepatitis B e antigen (HBeAg)-positive mothers and mothers with high HBV DNA titers. The remaining 4 babies tested positive for HBsAg and negative for antibodies, indicative of active HBV infection. The mothers of all 4 had viral loads ≥8×10(6) copies/ml in the third trimester. Although inadequate response or nonresponse to HBV vaccine was more common among babies born to HBeAg-positive and/or high viral load mothers, these risk factors did not completely predict nonresponsiveness. All babies born to HBV-infected mothers should be tested upon completion of the vaccine series to ascertain adequate protection. Some babies of HBeAg-positive mothers with high viral load may still become HBV infected despite timely immunoprophylaxis with HBV vaccine and HBIG.
在乙型肝炎病毒（HBV）流行的地区，围产期传播很常见。受感染的新生儿有90%的几率发展为慢性HBV感染，四分之一的人会因HBV相关肝病而过早死亡。2010年，乙肝基金会和海门市疾病预防控制中心在中国海门市发起了“关爱之门”运动，以提高全市对HBV感染的认识、预防和控制。该运动包括通过对所有孕妇进行乙肝表面抗原（HBsAg）筛查、对检测呈阳性者进行跟踪以及在其新生儿出生时给予免疫预防措施来预防围产期HBV传播。在接受筛查的5407名孕妇中，1
