St. Vincent's Hospital, Fitzroy, Australia Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia.
Institute of Liver and Digestive Health, Royal Free Hospital London, London, UK.
Gut. 2016 Feb;65(2):340-50. doi: 10.1136/gutjnl-2015-310317. Epub 2015 Oct 15.
Hepatitis B during pregnancy presents unique management issues for both the mother and fetus. These include the lack of a current cohesive strategy for treatment and follow-up of mothers and their babies; the uncertain risk of postpartum HBV flares; the lack of randomised trial data on the safety and efficacy of antiviral treatment in pregnancy; the lack of head-to-head studies comparing different antivirals in pregnancy; and the lack of epidemiologic information regarding infection across different populations globally. This position paper provides a comprehensive review of the management of women with HBV infection prior to conception, throughout each stage of pregnancy and postpartum, as well as recommendations and clinical approaches for the follow-up of children born to infected mothers, based on available evidence in the literature and recommendations from international experts. Prevention of perinatal transmission is an important component of global efforts to reduce the burden of chronic HBV since vertical transmission is responsible for most of the chronic infection worldwide.
乙型肝炎病毒（HBV）感染是一种严重的全球公共卫生问题，可导致慢性肝脏疾病、肝硬化和肝癌。HBV 感染在妊娠期间呈现出独特的管理问题，既涉及母亲，也涉及胎儿。这些问题包括：缺乏当前针对母亲及其婴儿的治疗和随访的连贯策略；产后 HBV 复发的风险不确定；缺乏关于妊娠期间抗病毒治疗安全性和有效性的随机临床试验数据；缺乏比较不同抗病毒药物在妊娠期间的头对头研究；以及缺乏关于全球不同人群感染情况的流行病学信息。本立场文件基于文献中的现有证据和国际专家的建议，对孕前、整个妊娠期间和产后 HBV 感染妇女的管理进行了全面审查，并就感染母亲所生儿童的随访提出了建议和临床方法。预防围产期传播是降低全球慢性 HBV 负担的重要组成部分，因为垂直传播是导致全球大多数慢性感染的原因。
