中文English
ISSN 1001-5256
CN 22-1108/R

留言板

尊敬的读者、作者、审稿人, 关于本刊的投稿、审稿、编辑和出版的任何问题, 您可以本页添加留言。我们将尽快给您答复。谢谢您的支持!

姓名
邮箱
手机号码
标题
留言内容
验证码

慢性HBV感染孕妇和儿童的抗病毒治疗药物选择及疗效评价

崔傲雪 窦晓光 丁洋

引用本文:
Citation:

慢性HBV感染孕妇和儿童的抗病毒治疗药物选择及疗效评价

DOI: 10.3969/j.issn.1001-5256.2022.11.003
基金项目: 

国家十三五科技重点专项 2017ZX10201201

利益冲突声明:所有作者均声明不存在利益冲突。
作者贡献声明:崔傲雪负责查找文献,分析资料,撰写文稿;窦晓光和丁洋负责确定写作思路,指导文章撰写及最后定稿。
详细信息
    通信作者:

    丁洋,yding0903@sina.com

Antiviral therapy for pregnant women and children with chronic HBV infection

Research funding: 

National Science and Technology Major Project during the 13th Five-Year Plan Period 2017ZX10201201

More Information
  • 摘要: 加强慢性HBV感染孕妇及其所分娩婴儿的规范化管理是切断HBV母婴传播、确保母婴安全和降低儿童慢性HBV感染的最主要措施。孕妇和儿童是特殊人群,慢性HBV感染孕妇和儿童的抗病毒治疗不论药物选择和疗效评价都与一般人群不同。本文将对慢性HBV感染孕妇和儿童的抗病毒治疗的药物选择及疗效评价进行归纳和总结,以期对慢性HBV感染孕妇和儿童更好地进行管理和治疗。

     

  • [1] LIU J, WANG XY, WANG Q, et al. Hepatitis B virus infection among 90 million pregnant women in 2853 Chinese counties, 2015-2020: a national observational study[J]. Lancet Reg Health West Pac, 2021, 16: 100267. DOI: 10.1016/j.lanwpc.2021.100267.
    [2] DING Y, SHENG QJ, MA L, et al. Chronic HBV infection among pregnant women and their infants in Shenyang, China[J]. Virol J, 2013, 10: 17. DOI: 10.1186/1743-422X-10-17.
    [3] World Health Origanization. Prevention of mother-to-child transmission of hepatitis B virus: guidelines on antiviral Prophylaxis in Pregnancy[EB/OL]. (2020-07-27)[2021-02-01] https://www.who.int/publications/i/item/978-92-4-000270-8
    [4] TERRAULT NA, FELD JJ, LOK ASF. Tenofovir to prevent perinatal transmission of hepatitis B[J]. N Engl J Med, 2018, 378(24): 2348-2349. DOI: 10.1056/NEJMc1805396.
    [5] Chinese Society of Infectious Diseases, Chinese Medical Association; China Grade Center. 2019 Chinese practice guideline for prevention and treatment of hepatitis B virus mother-to-child transmission[J]. Chin J Infect Dis, 2019, 37(7): 388-396. DOI: 10.3760/cma.j.issn.1674-2397.2019.05.001.

    中华医学会感染病学分会, 中国Grade中心. 中国乙型肝炎病毒母婴传播防治指南(2019年版)[J]. 中华传染病杂志, 2019, 37(7): 388-396. DOI: 10.3760/cma.j.issn.1674-2397.2019.05.001.
    [6] CUI FQ, WOODRING J CHAN P, et al. Considerations of antiviral treatment to interrupt mother-to-child transmission of hepatitis B virus in China[J]. Int J Epidemiol, 2018, 47(5): 1529-1537. DOI: 10.1093/ije/dyy077.
    [7] DING Y, DOU XG. Antiviral treatment strategy of hepatic flare in pregnant women with chronic hepatitis B[J]. Chin J Prac Int Med, 2017, 37(12): 1047-1048. DOI: 10.19538/j.nk2017120103.

    丁洋, 窦晓光. 妊娠期慢性乙型肝炎发作抗病毒治疗策略[J]. 中国实用内科杂志, 2017, 37(12): 1047-1048. DOI: 10.19538/j.nk2017120103.
    [8] CUI FQ, SHEN LP, LI L, et al. Prevention of chronic hepatitis B after 3 Decades of escalating vaccination policy, China[J]. Emerg Infect Dis, 2017, 23(5): 765-772. DOI: 10.3201/eid2305.161477.
    [9] ZHANG HF. Antiviral therapy in children hepatitis B patients[J]. Chin J Hepatol, 2010, 18(7): 495-497. DOI: 10.3760/cma.j.issn.1007-3418.2010.07.006.

    张鸿飞. 儿童慢性乙型肝炎的抗病毒治疗[J]. 中华肝脏病杂志, 2010, 18(7): 495-497. DOI: 10.3760/cma.j.issn.1007-3418.2010.07.006.
    [10] Chinese Foundation for Hepatitis Prevention and Control; Chinese Society of Infectious Diseases, Chinese Medical Association; Chinese Society of Hepatology, Chinese Medical Association. Management algorithm for prevention mother-to-child transmission of hepatitis B virus (2021)[J]. J Clin Hepatol, 2021, 37(3): 527-531. DOI: 10.3969/j.issn.1001-5256.2021.03.007.

    中国肝炎防治基金会, 中华医学会感染病学分会, 中华医学会肝病学分会. 阻断乙型肝炎病毒母婴传播临床管理流程(2021年)[J]. 临床肝胆病杂志, 2021, 37(3): 527-531. DOI: 10.3969/j.issn.1001-5256.2021.03.007.
    [11] PAN CQ, DUAN ZP, DAI E, et al. Tenofovir to prevent hepatitis B transmission in mothers with high viral load[J]. N Engl J Med, 2016, 374(24): 2324-2334. DOI: 10.1056/NEJMoa1508660.
    [12] CHEN HL, LEE CN, CHANG CH, et al. Efficacy of maternal tenofovir disoproxil fumarate in interrupting mother-to-infant transmission of hepatitis B virus[J]. Hepatology, 2015, 62(2): 375-386. DOI: 10.1002/hep.27837.
    [13] DING Y, CAO LH, ZHU LY, et al. Efficacy and safety of tenofovir alafenamide fumarate for preventing mother-to-child transmission of hepatitis B virus: a national cohort study[J]. Aliment Pharmacol Ther, 2020, 52(8): 1377-1386. DOI: doi: 10.1111/apt.16043.
    [14] ZENG QL, YU ZJ, JI FP, et al. Tenofovir alafenamide to prevent perinatal hepatitis B transmission: a multicenter, prospective, observational study[J]. Clin Infect Dis, 2021, 73(9): e3324-e3332. DOI: 10.1093/cid/ciaa1939.
    [15] LI BJ, LIU ZZ, LIU X, et al. Efficacy and safety of tenofovir disoproxil fumarate and tenofovir alafenamide fumarate in preventing HBV vertical transmission of high maternal viral load[J]. Hepatol Int, 2021, 15(5): 1103-1108. DOI: 10.1007/s12072-021-10235-1.
    [16] YANG N, ZHOU GL, CHENG XL, et al. Distribution evaluation of tenofovir in the breast milk of mothers with HBeAg-positive chronic HBV infection after treatment with tenofovir alafenamide and tenofovir disoproxil fumarate by a sensitive UPLC-MS/MS method[J]. Front Pharmacol, 2021, 12: 734760. DOI: 10.3389/fphar.2021.734760.
    [17] CHANG CY, AZIZ N, POONGKUNRAN M, et al. Serum alanine aminotransferase and hepatitis B DNA flares in pregnant and postpartum women with chronic hepatitis B[J]. Am J Gastroenterol, 2016, 11(10): 1410-1415. DOI: 10.1038/ajg.2016.296.
    [18] KUSHNER T, SHAW PA, KALRA A, et al. Incidence, determinants and outcomes of pregnancy-associated hepatitis B flares: A regional hospital-based cohort study[J]. Liver Int, 2018, 38(5): 813-820. DOI: 10.1111/liv.13594.
    [19] DING Y, SHENG QJ, ZHANG C, et al. Clinical characteristics of hepatic flare and efficacy of antiviral therapy in pregnant women with chronic hepatitis B virus infection[J]. Chin J Hepatol, 2019, 27(2): 106-111. DOI: 10.3760/cma.j.issn.1007-3418.2019.02.007.

    丁洋, 盛秋菊, 张翀, 等. 慢性乙型肝炎病毒感染孕妇妊娠期肝炎发作的临床特点及抗病毒治疗的疗效[J]. 中华肝脏病杂志, 2019, 27(2): 106-111. DOI: 10.3760/cma.j.issn.1007-3418.2019.02.007.
    [20] ZENG QL, ZHANG HX, ZHANG JY, et al. Tenofovir alafenamide for pregnant chinese women with active chronic hepatitis B: a multicenter prospective study[J]. Clin Gastroenterol Hepatol, 2021. DOI: 10.1016/j.cgh.2021.12.012.[Online ahead of print]
    [21] MASON WS, GILL US, LITWIN S, et al. HBV DNA integration and clonal hepatocyte expansion in chronic hepatitis B patients considered immune tolerant[J]. Gastroenterology, 2016, 151(5): 986-998.e4. DOI: 10.1053/j.gastro.2016.07.012.
    [22] XU ZQ, DONG Y, WANG FC, et al. Value of transient elastography in the diagnosis of liver fibrosis in chronic hepatitis B children of different ages[J]. J Clin Hepatol, 2020, 36(6): 78-82. DOI: 10.3969/j.issn.1001-5256.2020.06.016.

    徐志强, 董漪, 王福川, 等. 瞬时弹性成像对不同年龄慢性乙型肝炎肝纤维化患儿的诊断价值[J]. 临床肝胆病杂志, 2020, 36(6): 78-82. DOI: 10.3969/j.issn.1001-5256.2020.06.016.
    [23] LIU QC, LIN SW, CAI WP, et al. Analysis of histopathological features of 124 children with chronic hepatitis B[J]. Chin J Exp Clin Viral, 2015, 29(4): 322-325. DOI: 10.3760/cma.j.issn.1003-9279.2015.04.011.

    刘启材, 林思炜, 蔡卫平, 等. 124例儿童慢性乙型肝炎肝组织病理变化特征分析[J]. 中华实验和临床病毒学杂志, 2015, 29(4): 322-325. DOI: 10.3760/cma.j.issn.1003-9279.2015.04.011.
    [24] WU JF, TAI CS, CHANG KC, et al. Baseline hepatitis B virus surface antigen titers in childhood predict the risk of advanced liver fibrosis in adulthood[J]. Clin Gastroenterol Hepatol, 2022. DOI: 10.1016/j.cgh.2022.02.046.[Online ahead of print]
    [25] DEFRESNE F, ETIENNE SOKAL E. Chronic hepatitis B in children: Therapeutic challenges and perspectives[J]. J Gastroenterol Hepatol, 2017, 32(2): 368-371. DOI: 10.1111/jgh.13459.
    [26] XU PF, DENG HL, WANG XY, et al. Short-term efficacy of antiviral therapy for 6 children with chronic hepatitis B[J/CD]. Chin J Exp Clin Infect Dis(Electronic Edition), 2020, 14(6): 518-522.

    徐鹏飞, 邓慧玲, 王小燕, 等. 六例慢性乙型肝炎儿童患者抗病毒治疗短期疗效[J/CD]. 中华实验和临床感染病杂志(电子版), 2020, 14(6): 518-522.
    [27] HE Y, YIN J, XU H. Efficacy and safety of pegylated interferon for the treatment of chronic hepatitis B in children and adolescents: a systematic review and meta-analysis[J]. Pediatr Infect Dis J, 2020, 39(12): 1121-1126. DOI: 10.1097/INF.0000000000002876.
    [28] WIRTH S, ZHANG H, HARDIKAR W, et al. Efficacy and safety of peginterferon alfa-2a (40KD) in children with chronic hepatitis B: the PEG-B-ACTIVE study[J]. Hepatology, 2018, 68(5): 1681-1694. DOI: 10.1002/hep.30050.
    [29] NING L, HUANG X, XU Y, et al. Boosting of hepatitis B virus-specific T cell responses after pegylated-Interferon-α-2a therapy for hepatitis B e antigen-positive pediatric patients[J]. J Interferon Cytokine Res, 2019, 39(12): 740-751. DOI: 10.1089/jir.2019.0042.
    [30] FAN HM, LIN LP, JIA SJ, et al. Interferon alpha treatment leads to a high rate of hepatitis B surface antigen seroconversion in Chinese children with chronic hepatitis B[J]. J Viral Hepat, 2019, 26(Suppl 1): 77-84. DOI: 10.1111/jvh.13165.
    [31] LIU YH, LI H, YAN XH, et al. Long-term efficacy and safety of peginterferon in the treatment of children with HBeAg-positive chronic hepatitis B[J]. J Viral Hepat, 2019, 26(Suppl 1): 69-76. DOI: 10.1111/jvh.13154.
    [32] JONAS MM, CHANG MH, SOKAL E, et al. Randomized, controlled trial of entecavir versus placebo in children with hepatitis B envelope antigen-positive chronic hepatitis B[J]. Hepatology, 2016, 63(2): 377-387. DOI: 10.1002/hep.28015.
    [33] ZHU SS, DONG Y, WANG LM, et al. Early initiation of antiviral therapy contributes to a rapid and significant loss of serum HBsAg in infantile-onset hepatitis B[J]. J Hepatol, 2019, 71(5): 871-875. DOI: 10.1016/j.jhep.2019.06.009.
    [34] WU JF, CHIU YC, CHANG KC, et al. Predictors of hepatitis B e antigen-negative hepatitis in chronic hepatitis B virus-infected patients from childhood to adulthood[J]. Hepatology, 2016, 63(1): 74-82. DOI: 10.1002/hep.28222.
    [35] DONG Y, LI MN, ZHU SS, et al. De novo combination antiviral therapy in e antigen-negative chronic hepatitis B virus-infected paediatric patients with advanced fibrosis[J]. J Viral Hepat, 2020, 27(12): 1338-1343. DOI: 10.1111/jvh.13372.
    [36] KENNEDY PTF, SANDALOVA E, JO J, et al. Preserved T-cell function in children and young adults with immune-tolerant chronic hepatitis B[J]. Gastroenterology, 2012, 143(3): 637-645. DOI: 10.1053/j.gastro.2012.06.009.
    [37] ZHU SS, ZHANG HF, DONG Y, et al. Antiviral therapy in hepatitis B virus-infected children with immune-tolerant characteristics: A pilot open-label randomized study[J]. J Hepatol, 2018, 68(6): 1123-1128. DOI: 10.1016/j.jhep.2018.01.037.
    [38] ROSENTHAL P, LING SC, BELLE SH, et al. Combination of entecavir/peginterferon alfa-2a in children with hepatitis B e antigen-positive immune tolerant chronic hepatitis B virus infection[J]. Hepatology, 2019, 69(6): 2326-2337. DOI: 10.1002/hep.30312.
    [39] PAN J, ZHANG M, YAO TT, et al. Efficiency and influencing factors of interferon therapy for 1-6 years old children with chronic hepatitis B[J]. Int J Virol, 2020, 27(3): 214-218. DOI: 10.3760/cma.j.issn.1673-4092.2020.03.009

    潘静, 张敏, 姚甜甜, 等. 干扰素治疗1~6岁慢性乙型肝炎的疗效及影响因素[J]. 国际病毒学杂志, 2020, 27(3): 214-218. DOI: 10.3760/cma.j.issn.1673-4092.2020.03.009
    [40] WANG LM, ZHAO JF, LIU JY et al. Long-term benefits of interferon-α therapy in children with HBeAg-positive immune-active chronic hepatitis B[J]. J Viral Hepat, 2021, 28(11): 1554-1562. DOI: 10.1111/jvh.13598.
  • 加载中
计量
  • 文章访问数:  207
  • HTML全文浏览量:  34
  • PDF下载量:  187
  • 被引次数: 0
出版历程
  • 收稿日期:  2022-07-03
  • 录用日期:  2022-08-05
  • 出版日期:  2022-11-20
  • 分享
  • 用微信扫码二维码

    分享至好友和朋友圈

目录

    /

    返回文章
    返回