Zhuang H
Department of Microbiology and Center of Infectious Diseases, Peking University Health Science Center, Beijing 100191, China.
Zhonghua Gan Zang Bing Za Zhi. 2016 Dec 20;24(12):881-884. doi: 10.3760/cma.j.issn.1007-3418.2016.12.001.
Mother-to-child transmission (MTCT) is a major mode of hepatitis B virus (HBV) transmission, especially in high endemic areas. Administration of hepatitis B immunoglobulin (HBIG) and hepatitis B vaccine to infants at birth, followed by completion of the vaccine series, prevented approximately 95% of HBV transmission from HBsAg-positive mothers to their infants. However, immunoprophylaxis failure was still observed in 5~10% infants born to mothers with high levels of viremia. It was demonstrated that antiviral nucleot(s)ide analogues (NUCs) provided to pregnant women with high viral loads in late pregnancy further reduced MTCT. This paper discussed criteria of antiviral treatment for prevention of MTCT including threshold of HBV DNA level in pregnant women, time of starting treatment, time of stopping treatment, and kind of NUCs. The route of hepatitis B vaccine administration was also discussed.
母婴传播（MTCT）是乙型肝炎病毒（HBV）传播的主要途径，在高流行地区尤为如此。婴儿出生时接种乙型肝炎免疫球蛋白（HBIG）和乙型肝炎疫苗，随后完成整个疫苗接种程序，可预防约95%的HBV从HBsAg阳性母亲传播给婴儿。然而，在病毒血症水平高的母亲所生的婴儿中，仍有5%至10%观察到免疫预防失败。研究表明，在妊娠晚期为病毒载量高的孕妇提供抗病毒核苷（酸）类似物（NUCs）可进一步降低母婴传播。本文讨论了预防母婴传播的抗病毒治疗标准，包括孕妇HBV DNA水平阈值、开始治疗时间、停止治疗时间以及NUCs种类。还讨论了乙型肝炎疫苗的接种途径。
