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越南海防地区乙型肝炎感染和母婴传播:一项队列研究及其对干预措施的意义。

Hepatitis B Infection and Mother-to-Child Transmission in Haiphong, Vietnam: A Cohort Study with Implications for Interventions.

机构信息

Faculty of Public Health, Haiphong University of Medicine and Pharmacy, Haiphong, Vietnam.

Department of Tropical and Infectious Diseases, Viet-Tiep Hospital, Haiphong, Vietnam.

出版信息

Biomed Res Int. 2020 Aug 20;2020:4747965. doi: 10.1155/2020/4747965. eCollection 2020.

Abstract

BACKGROUND

There is little data available on HBV infection and mother-to-child transmission (MTCT) in Vietnam.

OBJECTIVE

This study is aimed at assessing the prevalence of HBV infection and the current situation of MTCT in Haiphong, Vietnam.

METHODS

A transversal survey of 1721 pregnant women followed by an observational prospective cohort study of 183 HBV-infected women was conducted at Haiphong Gyneco-Obstetric Hospital. Women were followed up up to 12-month postpartum; use of prevention measures and the MTCT rate were evaluated. HBV infection in children was defined by a HBsAg-positive test at 12 months of age.

RESULTS

At baseline, 183 of 1721 pregnant women (10.6%) tested HBsAg positive. Among them, 23.0% were HBeAg positive, 26.2% had a detectable load of HBV DNA, and 13.1% had a HBV DNA load ≥ 200,000 IU/mL. All women underwent MTCT prevention antiviral therapy. At delivery, 98.9% of newborns receive a HBV vaccine birth dose, and 82% received HBIG. At 12 months of age, 94.7% have received the scheduled HBV vaccines. Eight percent of infants born from followed-up women were HBsAg positive. The mother's HBeAg-positive status was associated with a higher risk of HBV infection in infants.

CONCLUSION

The HBV prevalence and MTCT rates are high in Haiphong. A strong national plan to increase the access to preventive measures and to monitor results is needed in order to decrease this prevalence.

摘要

背景

越南有关乙型肝炎病毒(HBV)感染和母婴传播(MTCT)的数据较少。

目的

本研究旨在评估越南海防市 HBV 感染的流行率和 MTCT 现状。

方法

在海防妇产科医院进行了一项横断面调查,共纳入 1721 名孕妇,随后对 183 名 HBV 感染孕妇进行了前瞻性队列观察研究。对这些孕妇进行了长达 12 个月的产后随访;评估了预防措施的使用情况和 MTCT 率。儿童 HBV 感染定义为 12 个月龄时 HBsAg 阳性检测结果。

结果

在基线时,1721 名孕妇中有 183 名(10.6%)HBsAg 阳性。其中,23.0%为 HBeAg 阳性,26.2%HBV DNA 可检测,13.1%HBV DNA 载量≥200000 IU/mL。所有女性均接受了 MTCT 预防抗病毒治疗。在分娩时,98.9%的新生儿接受了乙型肝炎疫苗基础免疫,82%的新生儿接受了乙型肝炎免疫球蛋白。在 12 个月龄时,94.7%的儿童接受了计划的乙型肝炎疫苗接种。在接受随访的女性所生的婴儿中,有 8%HBsAg 阳性。母亲 HBeAg 阳性状态与婴儿 HBV 感染风险增加相关。

结论

海防市 HBV 流行率和 MTCT 率较高。为降低这一流行率,需要国家制定强有力的计划,增加预防措施的可及性并监测结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3118/7455825/4bc9f82b1b6e/BMRI2020-4747965.001.jpg

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