[转移帖]最新发表在Gastroenterology上关于HBV母婴传播及阻断相关的文章
原帖由lbllf520 发表于 2011-12-29 12:12 ：Effects of Maternal Screening and Universal Immunization to Prevent Mother-To-Infant Transmission of HBV.
Chen HL, Lin LH, Hu FC, Lee JT, Lin WT, Yang YJ, Huang FC, Wu SF, Chen SC, Wen WH, Chu CH, Ni YH, Hsu HY, Tsai PL, Chiang CL, Shyu MK, Lee PI, Chang FY, Chang MH.
Source
Department of Pediatrics, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan; Department of Primary Care Medicine, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan; Department of Hepatitis Research Center, National Taiwan University Hospital, Taipei, Taiwan.
Abstract
BACKGROUND & AIMS:
Mother-to-infant transmission is the major cause of hepatitis B virus (HBV) infection among immunized children. There has been much debate about screening pregnant women and administering hepatitis B immunoglobulin (HBIG) to newborns. We analyzed the rate of HBV infection among children born to hepatitis B surface antigen (HBsAg)-positive mothers and whether HBIG administration reduces transmission.
METHODS:
We analyzed data from 2356 children born to HBsAg-positive mothers, identified through prenatal maternal screens. In addition to HBV vaccines, HBIG was given to all 583 children with hepatitis B e antigen (HBeAg)-positive mothers and to 723/1773 children with HBeAg-negative mothers. Serology tests for HBV were performed from 2007 to 2009, when children were 0.5-10 years old.
RESULTS:
A significantly greater percentage of children with HBeAg-positive mothers tested positive for antibodies against the hepatitis B core protein (anti-HBc, 16.76%) and HBsAg (9.26%) than children with HBeAg-negative mothers (1.58% and 0.29%, respectively; P<.0001 and <.001). Among the HBV infected children, the rate of chronicity was also higher among children with HBeAg-positive mothers than children with HBeAg-negative mothers (54% vs 17%; P=.002). Similar rates of anti-HBc (0.99% and 1.88%; P=.19) and HBsAg (0.14% and 0.29%; P=.65) were noted in children born to HBeAg-negative mothers that were or were not given HBIG. Infantile fulminant hepatitis developed in 1/1050 children who did not receive HBIG (.095%).
CONCLUSIONS:
Children born to HBeAg-positive mothers are at greatest risk for chronic HBV infection (9.26%), despite immunization. Administration of HBIG to infants born to HBeAg-negative mothers did not appear to reduce the rate of chronic HBV infection, but might prevent infantile fulminant hepatitis. Screening pregnant women for HBsAg and HBeAg might control mother-to-infant transmission of HBV.
Copyright © 2011 AGA Institute. Published by Elsevier Inc. All rights reserved.
lbllf520 发表于 2011-12-29 12:13
中文翻译，不妥之处还请指出。谢谢
背景和目的：在免疫儿童中，母婴传播是乙型肝炎病毒感染的主要途径。关于孕妇筛查和新生儿乙肝球蛋白（HBIG）治疗，还存在很多争议。我们分析了由乙型肝炎表面抗原（HBsAg）阳性的母亲生育的儿童中HBV感染的比例，以及HBIG治疗是否能减少传播。
方法：通过产前筛查，我们确定了2356例由HBsAg阳性母亲生产的儿童。除了接种疫苗，所有583例乙型肝炎e抗原（HBeAg）阳性母亲生产的儿童均接受了HBIG治疗，1773例HBeAg阴性的母亲中，723例生产的儿童接受了HBIG治疗。在2007-2009年间进行了HBV血清学检测，此时儿童的年龄在半岁至10岁间。
结果：在HBeAg阳性母亲中，小孩抗乙肝核心抗体（anti-HBc, 16.76%）和HBsAg（9.26%）阳性的比例要显著高于HBeAg阴性的母亲（分别为1.58%和0.29%; P<.0001和P<.001）。在受HBV感染的儿童中，由HBeAg阳性母亲所生的孩子中慢性化的比例也高于HBeAg阴性母亲所生的孩子（54% vs 17%，P=.002）。相似的抗HBc (0.99%和1.88%; P=.19）比例和HBsAg（0.14%和0.29%; P=.65）比例出现在给予或未给予HBIG治疗的HBeAg阴性母亲生产的儿童中。在未接受HBIG治疗的1050名儿童中，出现了1例小儿爆发性肝炎（.095%）。
结论：尽管接受了免疫，HBeAg阳性母亲生产的孩子存在巨大的HBV慢性感染的风险（9.26%）。HBIG治疗并不会减少HBeAg阴性母亲生产的孩子HBV慢性感染的风险，但可能阻止小儿爆发性肝炎。孕妇HBsAg和HBeAf筛查可能控制HBV母婴传播。
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