Zhou Mingshu, Li Li, Han Lirong, Sun Fangli, Yi Nuo
Department of Obstetrics and Gynecology, Beijing Ditan Hospital Capital Medical University, Beijing, China.
Int J Gen Med. 2021 May 11;14:1819-1827. doi: 10.2147/IJGM.S289804. eCollection 2021.
This study aims at researching the content of hepatitis B virus (HBV) DNA in the breast milk of the mothers carrying HBV and investigating the effects of different feeding methods on mother-to-child transmission (MTCT) of HBV.
All infants were voluntarily chosen by their mothers and divided into breast-feeding group and formula-feeding group, which were divided into three subgroups, respectively: HBV-DNA negative (HBV-) group, low viral load (LVL) group and high viral load (HVL) group.
HBV load in colostrum and mature milk were both significantly lower than in serum (P < 0.001). The positive rate of HBV-DNA in colostrum was positively correlated with HBV load in serum, significantly higher than that of the HBV-Group in colostrum in the LVL Group (P < 0.05), and the HVL Group was significantly higher than the LVL Group (P < 0.001). The analysis of risk factors of HBV infection in infants showed that breast-feeding and HBsAg positive in colostrum did not increase the risks of HBV infection of infants (P > 0.05).
Breast-feeding is safe for infants with HBV-infected mothers who receive active immunization combined with passive immunization. As well, breast-feeding will neither increase the risks of HBV infection for infants nor weaken their immunity to HBV. However, breast-feeding shall be cautiously applied to pregnant women with high viral load.
本研究旨在探讨乙型肝炎病毒（HBV）感染母亲乳汁中HBV DNA的含量，并研究不同喂养方式对HBV母婴传播（MTCT）的影响。
所有婴儿均由其母亲自愿选择，分为母乳喂养组和配方奶喂养组，每组再分为三个亚组：HBV-DNA阴性（HBV-）组、低病毒载量（LVL）组和高病毒载量（HVL）组。
初乳和成熟乳中的HBV载量均显著低于血清中的HBV载量（P<0.001）。初乳中HBV-DNA阳性率与血清中HBV载量呈正相关，LVL组初乳中HBV-DNA阳性率显著高于HBV-组（P<0.05），HVL组显著高于LVL组（P<0.001）。婴儿HBV感染危险因素分析显示，母乳喂养和初乳中HBsAg阳性均未增加婴儿HBV感染风险（P>0.05）。
对于接受主动免疫联合被动免疫的HBV感染母亲的婴儿，母乳喂养是安全的。而且，母乳喂养既不会增加婴儿HBV感染风险，也不会削弱其对HBV的免疫力。然而，高病毒载量的孕妇应谨慎应用母乳喂养。
