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香港乙型肝炎带菌孕妇对乙型肝炎感染管理的知识、认知和期望。

Knowledge, perception and expectation of management of hepatitis B infection among pregnant hepatitis B carriers in Hong Kong.

机构信息

Department of Obstetrics and Gynaecology, Queen Mary Hospital, the University of Hong Kong, Hong Kong SAR, China.

Department of Obstetrics & Gynaecology, Tuen Mun Hospital, Hong Kong SAR, China.

出版信息

J Viral Hepat. 2021 Dec;28(12):1699-1709. doi: 10.1111/jvh.13609. Epub 2021 Sep 6.

Abstract

Lack of awareness regarding the risk of hepatitis B virus (HBV) infection and the interventions available during pregnancy among the pregnant carriers may influence their willingness and adherence to the management. This study assessed the knowledge, perception and expectation of HBV infection among pregnant HBV carriers in Hong Kong. A prospective multicentre cross-sectional questionnaire study was carried out between August 2019 and April 2021. The general knowledge on HBV, perception and expectation, and interventions to reduce vertical transmission were questioned. Obtaining ≥70% correct answers was defined as having sufficient knowledge. 422 (82.7%) were known carriers. Only 18.4% of women had sufficient overall knowledge. The correct answer rates and percentage of sufficient knowledge were statistically lower for HBV knowledge specific to pregnancy compared with general knowledge (42.5% vs. 58.5%, p < 0.001; 8.8% vs. 30.2%, p < 0.001 respectively). Multiple logistic regression showed higher education and receiving HBV medical care within a year prior to pregnancy were associated with sufficient overall (OR 3.46; 95% CI 2.05-5.83 and OR 2.76; 95% CI 1.62-4.7, p < 0.001), and general knowledge (OR 2.86; 95% CI 1.81-4.51 and OR 2.14; 95% CI 1.33-3.44, p < 0.05). 298 (58.4%), 357 (70.0%) and 150 (29.4%) women believed they should receive care by obstetrician, hepatologist or general practitioner respectively. 46.9% did not want to initiate antiviral treatment due to the cost, perceived teratogenicity and maternal side effects. The knowledge of HBV among pregnant carriers in Hong Kong was poor despite the majority of them being aware of their carrier status prior to the pregnancy.

摘要

乙肝病毒(HBV)感染风险以及孕妇携带乙肝病毒时可采取的干预措施意识缺乏,可能影响其管理的意愿和依从性。本研究评估了香港乙肝病毒携带孕妇对 HBV 感染的认知、看法和期望。2019 年 8 月至 2021 年 4 月进行了一项前瞻性多中心横断面问卷调查研究。调查了对 HBV 的一般知识、看法和期望,以及降低垂直传播的干预措施。获得≥70%的正确答案被定义为具有足够的知识。422 名(82.7%)为已知携带者。只有 18.4%的女性具有足够的总体知识。与一般知识相比,针对妊娠的 HBV 知识的正确答案率和具有足够知识的百分比统计上较低(42.5%比 58.5%,p<0.001;8.8%比 30.2%,p<0.001)。多因素逻辑回归显示,较高的教育程度和在怀孕前一年内接受乙肝医疗保健与具有足够的总体知识(OR 3.46;95%CI 2.05-5.83 和 OR 2.76;95%CI 1.62-4.7,p<0.001)和一般知识(OR 2.86;95%CI 1.81-4.51 和 OR 2.14;95%CI 1.33-3.44,p<0.05)相关。298 名(58.4%)、357 名(70.0%)和 150 名(29.4%)妇女分别认为她们应该接受产科医生、肝病专家或全科医生的治疗。由于成本、潜在致畸性和母亲的副作用,46.9%的妇女不愿意开始抗病毒治疗。尽管大多数孕妇在怀孕前就已经知道自己是携带者,但她们对 HBV 的了解甚少。

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