Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC.
University of California, Berkeley School of Public Health, Berkeley, California.
MMWR Recomm Rep. 2018 Jan 12;67(1):1-31. doi: 10.15585/mmwr.rr6701a1.
HEPATITIS B VIRUS (HBV) IS TRANSMITTED VIA BLOOD OR SEXUAL CONTACT. PERSONS WITH CHRONIC HBV INFECTION ARE AT INCREASED RISK FOR CIRRHOSIS AND LIVER CANCER AND REQUIRE MEDICAL CARE. THIS REPORT UPDATES AND SUMMARIZES PREVIOUSLY PUBLISHED RECOMMENDATIONS FROM THE ADVISORY COMMITTEE ON IMMUNIZATION PRACTICES (ACIP) AND CDC REGARDING THE PREVENTION OF HBV INFECTION IN THE UNITED STATES. ACIP RECOMMENDS TESTING ALL PREGNANT WOMEN FOR HEPATITIS B SURFACE ANTIGEN (HBSAG), AND TESTING HBSAG-POSITIVE PREGNANT WOMEN FOR HEPATITIS B VIRUS DEOXYRIBONUCLEIC ACID (HBV DNA); ADMINISTRATION OF HEPB VACCINE AND HEPATITIS B IMMUNE GLOBULIN (HBIG) FOR INFANTS BORN TO HBV-INFECTED WOMEN WITHIN 12 HOURS OF BIRTH, FOLLOWED BY COMPLETION OF THE VACCINE SERIES AND POSTVACCINATION SEROLOGIC TESTING; UNIVERSAL HEPATITIS B VACCINATION WITHIN 24 HOURS OF BIRTH, FOLLOWED BY COMPLETION OF THE VACCINE SERIES; AND VACCINATION OF CHILDREN AND ADOLESCENTS AGED <19 YEARS WHO HAVE NOT BEEN VACCINATED PREVIOUSLY. ACIP RECOMMENDS VACCINATION OF ADULTS AT RISK FOR HBV INFECTION, INCLUDING UNIVERSAL VACCINATION OF ADULTS IN SETTINGS IN WHICH A HIGH PROPORTION HAVE RISK FACTORS FOR HBV INFECTION AND VACCINATION OF ADULTS REQUESTING PROTECTION FROM HBV WITHOUT ACKNOWLEDGMENT OF A SPECIFIC RISK FACTOR. THESE RECOMMENDATIONS ALSO PROVIDE CDC GUIDANCE FOR POSTEXPOSURE PROPHYLAXIS FOLLOWING OCCUPATIONAL AND OTHER EXPOSURES. THIS REPORT ALSO BRIEFLY SUMMARIZES PREVIOUSLY PUBLISHED AMERICAN ASSOCIATION FOR THE STUDY OF LIVER DISEASEST GUIDELINES FOR MATERNAL ANTIVIRAL THERAPY TO REDUCE PERINATAL HBV TRANSMISSION.
乙型肝炎病毒（HBV）通过血液或性接触传播。慢性 HBV 感染者患肝硬化和肝癌的风险增加，需要医疗护理。本报告更新并总结了免疫实践咨询委员会（ACIP）和疾病预防控制中心（CDC）之前发布的关于预防美国 HBV 感染的建议。ACIP 建议对所有孕妇进行乙型肝炎表面抗原（HBSAG）检测，对 HBSAG 阳性的孕妇进行乙型肝炎病毒脱氧核糖核酸（HBV DNA）检测；对 HBV 感染的孕妇，在出生后 12 小时内为婴儿接种乙肝疫苗和乙肝免疫球蛋白（HBIG），然后完成疫苗系列接种和接种后血清学检测；对所有新生儿在出生后 24 小时内接种乙肝疫苗，然后完成疫苗系列接种；对以前未接种过疫苗的儿童和青少年进行接种。ACIP 建议对有感染 HBV 风险的成年人进行疫苗接种，包括在高比例有 HBV 感染风险因素的环境中对成年人进行普遍接种，以及对未承认特定风险因素但要求预防 HBV 的成年人进行疫苗接种。这些建议还为职业和其他暴露后的预防提供了 CDC 指导。本报告还简要总结了之前发布的美国肝脏病研究协会关于减少围产期 HBV 传播的母亲抗病毒治疗指南。
