Hospital Universitario San Cecilio, Granada, Spain.
CIBER de Enfermedades Hepáticas y Digestivas (CIBEREHD), CIBER, Madrid, Spain.
PLoS One. 2020 May 21;15(5):e0233528. doi: 10.1371/journal.pone.0233528. eCollection 2020.
BACKGROUND & AIM: Worldwide, measures are being implemented to eradicate hepatitis B (HBV) and C (HCV) viruses, which can be transmitted from the mother during childbirth. This study aims to determine the prevalence of HBV and HCV in pregnant women in Spain, focusing on country of origin, epidemiological factors and risk of vertical transmission (VT).
Multicentre open-cohort study performed during 2015. HBV prevalence was determined in 21870 pregnant women and HCV prevalence in 7659 pregnant women. Epidemiological and risk factors for VT were analysed in positive women and differences between HBV and HCV cases were studied.
HBV prevalence was 0.42% (91/21870) and HCV prevalence was 0.26% (20/7659). Of the women with HBV, 65.7% (44/67) were migrants. The HBV transmission route to the mother was unknown in 40.3% of cases (27/67) and VT in 31.3% (21/67). Among risk factors for VT, 67.7% (42/62) of the women had viraemia and 14.5% (9/62) tested HBeAg-positive. All of the neonates born to HBV-positive mothers received immunoprophylaxis, and none contracted infection by VT. In 80% (16/20) of the women with HCV, the transmission route was parenteral, and nine were intravenous drug users. Viraemia was present in 40% (8/20) of the women and 10% (2/20) were HIV-coinfected. No children were infected. Women with HCV were less likely than women with HBV to breastfeed their child (65% vs. 86%).
The prevalences obtained in our study of pregnant women are lower than those previously documented for the general population. Among the women with HBV, the majority were migrants and had a maternal family history of infection, while among those with HCV, the most common factor was intravenous drug use. Despite the risk factors observed for VT, none of the children were infected. Proper immunoprophylaxis is essential to prevent VT in children born to HBV-positive women.
在全球范围内，正在采取措施消灭乙型肝炎（HBV）和丙型肝炎（HCV）病毒，这些病毒可在分娩期间由母亲传播给婴儿。本研究旨在确定西班牙孕妇中 HBV 和 HCV 的流行率，重点关注原籍国、流行病学因素和垂直传播（VT）的风险。
这是一项在 2015 年进行的多中心开放队列研究。在 21870 名孕妇中确定了 HBV 的流行率，在 7659 名孕妇中确定了 HCV 的流行率。对阳性孕妇进行了 VT 的流行病学和危险因素分析，并研究了 HBV 和 HCV 病例之间的差异。
HBV 的流行率为 0.42%（91/21870），HCV 的流行率为 0.26%（20/7659）。在 HBV 阳性的孕妇中，65.7%（44/67）为移民。40.3%（27/67）的病例中，HBV 传播途径未知，31.3%（21/67）的病例中 VT。在 VT 的危险因素中，67.7%（42/62）的孕妇有病毒血症，14.5%（9/62）的 HBeAg 阳性。所有 HBV 阳性母亲所生的新生儿均接受了免疫预防，均未通过 VT 感染。在 80%（16/20）的 HCV 阳性孕妇中，传播途径为静脉内，9 例为静脉吸毒者。40%（8/20）的孕妇有病毒血症，10%（2/20）为 HIV 合并感染。没有儿童感染。与 HBV 阳性孕妇相比，HCV 阳性孕妇更不可能母乳喂养孩子（65%对 86%）。
我们对孕妇进行的研究中获得的流行率低于先前对一般人群的记录。在 HBV 阳性的孕妇中，大多数是移民，有感染的家族史，而在 HCV 阳性的孕妇中，最常见的因素是静脉内药物使用。尽管观察到了 VT 的危险因素，但没有一个孩子被感染。对 HBV 阳性母亲所生的儿童进行适当的免疫预防对于预防 VT 至关重要。
