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妊娠期抗病毒治疗阻断HBV母婴传播的新进展

韩国荣 江红秀

引用本文:
Citation:

妊娠期抗病毒治疗阻断HBV母婴传播的新进展

DOI: 10.12449/JCH241105
基金项目: 

国家“十三五”重大传染病防治科技专项 (2017ZX10201201-001-002);

国家“十三五”重大传染病防治科技专项 (2017ZX10201201-002-001);

江苏省医学创新团队项目 (CXTDA2017040)

利益冲突声明:本文不存在任何利益冲突。
作者贡献声明:韩国荣负责设计论文框架,起草并修改论文,最后定稿;江红秀负责拟定写作思路,撰写文章。
详细信息
    通信作者:

    韩国荣, hgr518@163.com (ORCID: 0000-0002-1397-8185)

New advances in antiviral therapy during pregnancy to block mother-to-child transmission of hepatitis B virus

Research funding: 

“13th Five-year" National Science and Technology Major Project for Infectious of China” (2017ZX10201201-001-002);

“13th Five-year" National Science and Technology Major Project for Infectious of China” (2017ZX10201201-002-001);

Medical Innovation Team Project of Jiangsu Province (CXTDA2017040)

More Information
    Corresponding author: HAN Guorong, hgr518@163.com (ORCID: 0000-0002-1397-8185)
  • 摘要: HBV母婴传播是导致我国慢性乙型肝炎疾病高负担的主要原因之一,阻断这一传播途径对消除乙型肝炎具有至关重要的战略意义。新生儿出生立即实施联合免疫接种是阻断HBV母婴传播的基本策略,但在高病毒血症母亲中仍有9%的母婴传播率。近年来,孕期抗病毒干预阻断母婴传播的研究取得了突破,对消除乙型肝炎母婴传播具有划时代意义。孕期抗病毒干预与婴儿出生后联合免疫接种的综合预防,已成为消除乙型肝炎母婴传播的关键策略。本文总结了妊娠期抗病毒干预阻断母婴传播的发展历程和最新进展,并归纳相关干预策略和适应证等,旨在为临床和公共卫生医生提供参考。

     

  • 表  1  不同指南中慢性HBV感染孕妇妊娠期抗病毒治疗建议

    Table  1.   Antiviral therapy recommendations for pregnant women with chronic HBV infection in different guidelines

    指南 首选药物 适应证 治疗时机
    中国指南201514 TDF/LdT/LAM >2×106 IU/mL 24~28周
    APASL 201616 TDF/LdT >1×106~7 IU/mL 28~32周
    AASLD 201615 LAM/TDF/LdT >2×105 IU/mL 28~32周
    EASL 201720 TDF >2×105 IU/mL或HBsAg>4 log10 IU/mL 24~28周
    AASLD 201822 TDF >2×105 IU/mL 28~32周
    中国指南201932 TDF/LdT >2×105 IU/mL 24~28周
    中国指南20223 TDF >2×105 IU/mL 24~28周
    APASL 202219 TDF >2×105 IU/mL或HBeAg阳性 24~28周
    EASL 202321 TDF >2×105 IU/mL或HBeAg阳性 24~28周
    中国指南202430 TDF/TAF ≥2×105 IU/mL 24~28周
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