Globally, hepatitis C virus (HCV) has infected an estimated 130 million people, most of whom are chronically infected. HCV-infected people serve as a reservoir for transmission to others and are at risk for developing...Globally, hepatitis C virus (HCV) has infected an estimated 130 million people, most of whom are chronically infected. HCV-infected people serve as a reservoir for transmission to others and are at risk for developing chronic liver disease, cirrhosis, and primary hepatocellular carcinoma (HCC). It has been estimated that HCV accounts for 27% of cirrhosis and 25% of HCC worldwide. HCV infection has likely been endemic in many populations for centuries. However, the wave of increased HCV-related morbidity and mortality that we are now facing is the result of an unprecedented increase in the spread of HCV during the 20th century. Two 20th century events appear to be responsible for this increase; the widespread availability of injectable therapies and the illicit use of injectable drugs.展开更多
AIM： To determine the therapeutic effect of lamivu- dine in late pregnancy for the interruption of motherto-child transmission （MTCT） of hepatitis B virus （HBV）. METHODS： Studies were identified by searching ava...AIM： To determine the therapeutic effect of lamivu- dine in late pregnancy for the interruption of motherto-child transmission （MTCT） of hepatitis B virus （HBV）. METHODS： Studies were identified by searching available databases up to January 2011. Inclusive criteria were HBV-carrier mothers who had been involved in randomized controlled clinical trials （RCTs） with lamivudine treatment in late pregnancy, and newborns or infants whose serum hepatitis B surface antigen （HBsAg）, hepatitis B e antigen （HBeAg） or HBV DNA had been documented. The relative risks （RRs） for inerruption of MTCT as indicated by HBsAg, HBV DNA or HBeAg of newborns or infants were calculated with 95% confidence interval （CI） to estimate the efficacy of lamivudine treatment. RESULTS： Fifteen RCTs including 1693 HBV-carrier mothers were included in this meta-analysis. The overall RR was 0.43 （95% CI, 0.25-0.76; 8 RCTs; Phet- erogeneity= 0.04） and 0.33 （95% CI, 0.23-0.47; 6 RCTs; Pheterogeneity = 0.93） indicated by newborn HBsAg or HBV DNA. The RR was 0.33 （95% CI, 0.21-0.50; 6 RCTs; Pheterogeneity = 0.46） and 0.32 （95% CI, 0.20-0.50; 4 RCTs; Pheterogeneity = 0.33） indicated by serum HBsAg or HBV DNA of infants 6-12 mo after birth. The RR （lamivudine vs hepatitis B immunoglobulin） was 0.27 （95% CI, 0.16-0.46; 5 RCTs; Pheterogeneity = 0.94） and 0.24 （95% CI, 0.07-0.79; 3 RCTs; Pheterogeneity = 0.60） indicated by newborn HBsAg or HBV DNA, respectively. In the mothers with viral load 〈 106 copies/mL after lamivudine treatment, the efficacy （RR, 95% CI） was 0.33, 0.21-0.53 （5 RCTs; Pheterogeneity = 0.82） for the interruption of MTCT, however, this value was not significant if maternal viral load was 〉 106 copies/mL after lamivudine treatment （P = 0.45, 2 RCTs）, as indicated by newborn serum HBsAg. The RR （lamivudine initiated from 28 wk of gestation vs control） was 0.34 （95% CI, 0.22-0.52; 7 RCTs; Pheterogeneity = 0.92） and 0.33 （95% CI, 0.22-0.50; 5 RCTs; Phetero展开更多
China has the world’s largest burden of hepatitis B virus(HBV)infection,but the country has made considerable progress in preventing its mother-to-child transmission(MTCT)in the past three decades.This feat is made p...China has the world’s largest burden of hepatitis B virus(HBV)infection,but the country has made considerable progress in preventing its mother-to-child transmission(MTCT)in the past three decades.This feat is made possible due to the high coverage of birth-dose hepatitis B vaccine(HepB,>95%),hepatitis B surface antigen(HBsAg)screening for pregnant women(>99%),and hepatitis B immunoglobulin plus HepB for newborns whose mothers are HBsAg positive(>99%).Studies on the optimal antiviral treatment regimen for pregnant women with high HBV-DNA load have also been conducted.However,China still faces challenges in eliminating MTCTof HBV.The overall HBsAg prevalence among pregnant women is considered an intermediate endemic.The prevalence of HBsAg among pregnant women from remote,rural,or ethnic minority areas is higher than that of the national level because of limited health resources and public health education for HBV.The coverage for maternal and child healthcare and immunization services should be improved,especially in western regions.Integration of current services to prevent MTCTof HBV with other relevant health services can increase the acceptability,efficiency,and coverage of these services,particularly in remote areas and ethnic minority areas.By doing so,progress toward key milestones and targets to eliminate hepatitis B as the main public health threat by 2030 can be achieved.展开更多
AIM:To examine the determinants of maternal-neonatal transmission of hepatitis B virus(HBV) METHODS:A nested case-control study was conducted in Changsha,Hunan,People's Republic of China from January 1,2005 to Sep...AIM:To examine the determinants of maternal-neonatal transmission of hepatitis B virus(HBV) METHODS:A nested case-control study was conducted in Changsha,Hunan,People's Republic of China from January 1,2005 to September 31,2006 To avoid potential maternal blood contamination,we collected vein blood of newborns immediately after birth and before initial hepatitis B vaccination to determine the HBV infection status of the newborn For each HBsAg-positive infant,one HBsAg-negative infant born to an HBsAg-positive mother was matched by hospital at birth(same),gender(same),and date of birth(within 1 mo) A faceto-face interview was conducted to collect clinical and epidemiological data Conditional logistic regression analysis was used to estimate the independent effects of various determinants on maternal-neonatal transmission of HBV RESULTS:A total of 141 HBsAg-positive infants and 141 individually matched HBsAg-negative infants were included in the final analysis Maternal first-degree family history of HBV infection,intrahepatic cholestasis,and premature rupture of membranes were risk factors for perinatal transmission of HBV,whereas systematic treatment and HBV immunoglobulin injections for mothers with HBV infection were protective factors for maternal-neonatal transmission of HBV,after adjustment for potential confounding factors CONCLUSION:For HBsAg-positive mothers,systematic treatment,HBV immunoglobulin administration,and controlling intrahepatic cholestasis and pregnancy complications may reduce the incidence of perinatal transmission of HBV.展开更多
In the past 37 years,human immunodeficiency virus/acquired immunodeficiency syndrome(HIV/AIDS)has undergone various major transmission routes in China,with the world most complex co-circulating HIV-1 subtypes,even the...In the past 37 years,human immunodeficiency virus/acquired immunodeficiency syndrome(HIV/AIDS)has undergone various major transmission routes in China,with the world most complex co-circulating HIV-1 subtypes,even the prevalence is still low.In response to the first epidemic outbreak of HIV in injecting drug users and the second one by illegal commercial blood collection,China issued the Anti-Drug Law and launched the Blood Donation Act and nationwide nucleic acid testing,which has avoided 98,232 to 211,200 estimated infections and almost ended the blood product-related infection.China has been providing free antiretroviral therapy(ART)since 2003,which covered>80%of the identified patients and achieved a viral suppression rate of 91%.To bend the curve of increasing the disease burden of HIV and finally end the epidemic,China should consider constraining HIV spread through sexual transmission,narrowing the gaps in identifying HIV cases,and the long-term effectiveness and safety of ART in the future.展开更多
Pregnancy associated with chronic hepatitis B (CHB) is a common and important problem with unique challenges. Pregnant women infected with CHB are different from the general population, and their special problems need...Pregnancy associated with chronic hepatitis B (CHB) is a common and important problem with unique challenges. Pregnant women infected with CHB are different from the general population, and their special problems need to be considered: such as the effect of hepatitis B virus (HBV) infection on the mother and fetus, the effect of pregnancy on replication of the HBV, whether mothers should take HBV antiviral therapy during pregnancy, the effect of these treatments on the mother and fetus, how to carry out immunization of neonates, whether it can induce hepatitis activity after delivery and other serious issues. At present, there are about 350 million individuals with HBV infection worldwide, of which 50% were infected during the perinatal or neonatal period, especially in HBV-endemic countries. Currently, the rate of HBV infection in thechild-bearing age group is still at a high level, and the infection rate is as high as 8.16%. Effective prevention of mother-to-child transmission is an important means of reducing the global burden of chronic HBV infection. Even after adopting the combined immunization measures, there are still 5%-10% of babies born with HBV infection in hepatitis B e antigen positive pregnant women. As HBV perinatal transmission is the main cause of chronic HBV infection, we must consider how to prevent this transmission to reduce the burden of HBV infection. In this population of chronic HBV infected women of childbearing age, specific detection, intervention and follow-up measures are particularly worthy of attention and discussion.展开更多
文摘Globally, hepatitis C virus (HCV) has infected an estimated 130 million people, most of whom are chronically infected. HCV-infected people serve as a reservoir for transmission to others and are at risk for developing chronic liver disease, cirrhosis, and primary hepatocellular carcinoma (HCC). It has been estimated that HCV accounts for 27% of cirrhosis and 25% of HCC worldwide. HCV infection has likely been endemic in many populations for centuries. However, the wave of increased HCV-related morbidity and mortality that we are now facing is the result of an unprecedented increase in the spread of HCV during the 20th century. Two 20th century events appear to be responsible for this increase; the widespread availability of injectable therapies and the illicit use of injectable drugs.
基金Supported by National Natural Science Foundation of China,No. 81025015 and No. 30921006
文摘AIM： To determine the therapeutic effect of lamivu- dine in late pregnancy for the interruption of motherto-child transmission （MTCT） of hepatitis B virus （HBV）. METHODS： Studies were identified by searching available databases up to January 2011. Inclusive criteria were HBV-carrier mothers who had been involved in randomized controlled clinical trials （RCTs） with lamivudine treatment in late pregnancy, and newborns or infants whose serum hepatitis B surface antigen （HBsAg）, hepatitis B e antigen （HBeAg） or HBV DNA had been documented. The relative risks （RRs） for inerruption of MTCT as indicated by HBsAg, HBV DNA or HBeAg of newborns or infants were calculated with 95% confidence interval （CI） to estimate the efficacy of lamivudine treatment. RESULTS： Fifteen RCTs including 1693 HBV-carrier mothers were included in this meta-analysis. The overall RR was 0.43 （95% CI, 0.25-0.76; 8 RCTs; Phet- erogeneity= 0.04） and 0.33 （95% CI, 0.23-0.47; 6 RCTs; Pheterogeneity = 0.93） indicated by newborn HBsAg or HBV DNA. The RR was 0.33 （95% CI, 0.21-0.50; 6 RCTs; Pheterogeneity = 0.46） and 0.32 （95% CI, 0.20-0.50; 4 RCTs; Pheterogeneity = 0.33） indicated by serum HBsAg or HBV DNA of infants 6-12 mo after birth. The RR （lamivudine vs hepatitis B immunoglobulin） was 0.27 （95% CI, 0.16-0.46; 5 RCTs; Pheterogeneity = 0.94） and 0.24 （95% CI, 0.07-0.79; 3 RCTs; Pheterogeneity = 0.60） indicated by newborn HBsAg or HBV DNA, respectively. In the mothers with viral load 〈 106 copies/mL after lamivudine treatment, the efficacy （RR, 95% CI） was 0.33, 0.21-0.53 （5 RCTs; Pheterogeneity = 0.82） for the interruption of MTCT, however, this value was not significant if maternal viral load was 〉 106 copies/mL after lamivudine treatment （P = 0.45, 2 RCTs）, as indicated by newborn serum HBsAg. The RR （lamivudine initiated from 28 wk of gestation vs control） was 0.34 （95% CI, 0.22-0.52; 7 RCTs; Pheterogeneity = 0.92） and 0.33 （95% CI, 0.22-0.50; 5 RCTs; Phetero
基金supported by the grant from the National Natural Science Foundation of China(Nos.71874003,71934002,and 81703240).
文摘China has the world’s largest burden of hepatitis B virus(HBV)infection,but the country has made considerable progress in preventing its mother-to-child transmission(MTCT)in the past three decades.This feat is made possible due to the high coverage of birth-dose hepatitis B vaccine(HepB,>95%),hepatitis B surface antigen(HBsAg)screening for pregnant women(>99%),and hepatitis B immunoglobulin plus HepB for newborns whose mothers are HBsAg positive(>99%).Studies on the optimal antiviral treatment regimen for pregnant women with high HBV-DNA load have also been conducted.However,China still faces challenges in eliminating MTCTof HBV.The overall HBsAg prevalence among pregnant women is considered an intermediate endemic.The prevalence of HBsAg among pregnant women from remote,rural,or ethnic minority areas is higher than that of the national level because of limited health resources and public health education for HBV.The coverage for maternal and child healthcare and immunization services should be improved,especially in western regions.Integration of current services to prevent MTCTof HBV with other relevant health services can increase the acceptability,efficiency,and coverage of these services,particularly in remote areas and ethnic minority areas.By doing so,progress toward key milestones and targets to eliminate hepatitis B as the main public health threat by 2030 can be achieved.
基金Supported by Hunan Ministry of Science and Technology,No.06FJ3177,China
文摘AIM:To examine the determinants of maternal-neonatal transmission of hepatitis B virus(HBV) METHODS:A nested case-control study was conducted in Changsha,Hunan,People's Republic of China from January 1,2005 to September 31,2006 To avoid potential maternal blood contamination,we collected vein blood of newborns immediately after birth and before initial hepatitis B vaccination to determine the HBV infection status of the newborn For each HBsAg-positive infant,one HBsAg-negative infant born to an HBsAg-positive mother was matched by hospital at birth(same),gender(same),and date of birth(within 1 mo) A faceto-face interview was conducted to collect clinical and epidemiological data Conditional logistic regression analysis was used to estimate the independent effects of various determinants on maternal-neonatal transmission of HBV RESULTS:A total of 141 HBsAg-positive infants and 141 individually matched HBsAg-negative infants were included in the final analysis Maternal first-degree family history of HBV infection,intrahepatic cholestasis,and premature rupture of membranes were risk factors for perinatal transmission of HBV,whereas systematic treatment and HBV immunoglobulin injections for mothers with HBV infection were protective factors for maternal-neonatal transmission of HBV,after adjustment for potential confounding factors CONCLUSION:For HBsAg-positive mothers,systematic treatment,HBV immunoglobulin administration,and controlling intrahepatic cholestasis and pregnancy complications may reduce the incidence of perinatal transmission of HBV.
基金the Mega-Projects of national science research(13rd Five-Year Plan[No.2017ZX10201101])the Innovation Team Develop-ment Program of the Ministry of Education 2016(No.IRT_16R70).
文摘In the past 37 years,human immunodeficiency virus/acquired immunodeficiency syndrome(HIV/AIDS)has undergone various major transmission routes in China,with the world most complex co-circulating HIV-1 subtypes,even the prevalence is still low.In response to the first epidemic outbreak of HIV in injecting drug users and the second one by illegal commercial blood collection,China issued the Anti-Drug Law and launched the Blood Donation Act and nationwide nucleic acid testing,which has avoided 98,232 to 211,200 estimated infections and almost ended the blood product-related infection.China has been providing free antiretroviral therapy(ART)since 2003,which covered>80%of the identified patients and achieved a viral suppression rate of 91%.To bend the curve of increasing the disease burden of HIV and finally end the epidemic,China should consider constraining HIV spread through sexual transmission,narrowing the gaps in identifying HIV cases,and the long-term effectiveness and safety of ART in the future.
基金Research Grant for Projects in Infectious Diseases from the Department of Health, Jiangsu Province, China, No. H200804
文摘Pregnancy associated with chronic hepatitis B (CHB) is a common and important problem with unique challenges. Pregnant women infected with CHB are different from the general population, and their special problems need to be considered: such as the effect of hepatitis B virus (HBV) infection on the mother and fetus, the effect of pregnancy on replication of the HBV, whether mothers should take HBV antiviral therapy during pregnancy, the effect of these treatments on the mother and fetus, how to carry out immunization of neonates, whether it can induce hepatitis activity after delivery and other serious issues. At present, there are about 350 million individuals with HBV infection worldwide, of which 50% were infected during the perinatal or neonatal period, especially in HBV-endemic countries. Currently, the rate of HBV infection in thechild-bearing age group is still at a high level, and the infection rate is as high as 8.16%. Effective prevention of mother-to-child transmission is an important means of reducing the global burden of chronic HBV infection. Even after adopting the combined immunization measures, there are still 5%-10% of babies born with HBV infection in hepatitis B e antigen positive pregnant women. As HBV perinatal transmission is the main cause of chronic HBV infection, we must consider how to prevent this transmission to reduce the burden of HBV infection. In this population of chronic HBV infected women of childbearing age, specific detection, intervention and follow-up measures are particularly worthy of attention and discussion.
