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孕妇和哺乳期妇女的猴痘病毒疫苗及抗病毒疗法:疗效与母婴结局

Vaccines and Antiviral Therapies for Mpox Virus in Pregnant and Breastfeeding Women: Efficacy and Maternal-Child Outcomes.

作者信息

Imran Maryum, Sohail Myra, Kamran Javeria, Abbas Syeda Qaima, Azeem Khadija, Korir Emmanuel

机构信息

Department of Medicine, Dow University of Health Sciences, Karachi 74200, Pakistan.

Department of Medicine, Ziauddin Medical College, Karachi 75000, Pakistan.

出版信息

Viruses. 2025 Mar 22;17(4):456. doi: 10.3390/v17040456.

Abstract

Mpox (formerly known as monkeypox), the major public health concern of 2022, has elicited much attention globally. In addition to the usual symptoms observed in smallpox virus infections, infected mothers were found to hold a possible risk of transmission to newborns during delivery. This review aimed to summarize recent clinical trials that involved antiviral therapy, vaccines, immunoglobulin therapy, and other pharmacological interventions specifically for treating infected pregnant women. A comprehensive search was performed using databases such as PubMed, Google Scholar, and Medline to find appropriate disease management strategies. Amongst the vaccines and antivirals being used for treatment, vaccines such as Modified Vaccinia Ankara (MVA/MVA-BN) and Lister clone 16-medium pocket size-8 (LC16m8), while prophylactically effective, have been deemed unsafe for pregnant and lactating females. Antivirals like Tecovirimat, on the other hand, are considered to be a better alternative, but they are not without risks that may outweigh the potential benefits. Additionally, efforts to reduce maternal and fetal complications include administering the MVA-BN vaccine and awareness campaigns regarding herd immunity. Therefore, necessary precautions, prophylactic vaccinations in high-risk outbreak regions, and symptomatic treatment in pregnant and lactating females currently appear to be more feasible approaches against the mpox virus.

摘要

猴痘(以前称为猴天花)是2022年主要的公共卫生问题,已引起全球广泛关注。除了天花病毒感染中常见的症状外,还发现感染的母亲在分娩期间有可能将病毒传播给新生儿。本综述旨在总结近期涉及抗病毒治疗、疫苗、免疫球蛋白治疗以及其他专门用于治疗感染孕妇的药物干预措施的临床试验。通过使用PubMed、谷歌学术和Medline等数据库进行全面检索,以寻找合适的疾病管理策略。在用于治疗的疫苗和抗病毒药物中,诸如安卡拉痘苗病毒(MVA/MVA-BN)和李斯特克隆16-中口袋大小-8(LC16m8)等疫苗,虽然具有预防效果,但被认为对怀孕和哺乳期女性不安全。另一方面,像特考韦瑞这样的抗病毒药物被认为是更好的选择,但它们也并非没有风险,其风险可能超过潜在益处。此外,减少母婴并发症的努力包括接种MVA-BN疫苗以及开展关于群体免疫的宣传活动。因此,目前采取必要的预防措施、在高风险爆发地区进行预防性接种以及对怀孕和哺乳期女性进行对症治疗,似乎是应对猴痘病毒更可行的方法。

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本文引用的文献

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Do breastfeeding mothers in DR Congo have access to the mpox vaccine?刚果民主共和国的母乳喂养母亲能够接种猴痘疫苗吗?
Lancet Glob Health. 2024 Dec;12(12):e1931. doi: 10.1016/S2214-109X(24)00423-6. Epub 2024 Oct 7.
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Vaccines against mpox: MVA-BN and LC16m8.针对猴痘的疫苗:MVA-BN 和 LC16m8。
Expert Rev Vaccines. 2024 Jan-Dec;23(1):796-811. doi: 10.1080/14760584.2024.2397006. Epub 2024 Sep 1.
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Monkeypox: An outbreak of a rare viral disease.猴痘:一种罕见病毒性疾病的爆发。
J Microbiol Immunol Infect. 2024 Feb;57(1):1-10. doi: 10.1016/j.jmii.2023.12.006. Epub 2023 Dec 28.
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