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
HBV母婴传播是导致慢性HBV感染的主要原因,即HBV阳性孕妇在妊娠期或分娩过程中将HBV传染给新生儿。如果对HBV阳性母亲所生新生儿不采取任何免疫预防措施,70%-90%的新生儿会感染HBV,而新生儿一旦感染,90%以上会发展为慢性HBV感染[1-2]。...HBV母婴传播是导致慢性HBV感染的主要原因,即HBV阳性孕妇在妊娠期或分娩过程中将HBV传染给新生儿。如果对HBV阳性母亲所生新生儿不采取任何免疫预防措施,70%-90%的新生儿会感染HBV,而新生儿一旦感染,90%以上会发展为慢性HBV感染[1-2]。自1992年我国开始将乙型肝炎疫苗（hepatitis B vaccine,HepB）纳入免疫规划管理,特别是自2002年HepB免费和2005年新生儿HepB接种完全免费以来,我国儿童和一般人群HBV感染率明显下降[3]。展开更多
目的：了解云南省德宏州2011—2013年期间预防艾滋病、梅毒和乙型肝炎母婴传播的效果。方法通过收集2011—2013年德宏州预防艾滋病、梅毒和乙型肝炎母婴传播工作报表数据，并对国家艾滋病综合防治数据信息系统和预防艾滋病母婴传播管理...目的：了解云南省德宏州2011—2013年期间预防艾滋病、梅毒和乙型肝炎母婴传播的效果。方法通过收集2011—2013年德宏州预防艾滋病、梅毒和乙型肝炎母婴传播工作报表数据，并对国家艾滋病综合防治数据信息系统和预防艾滋病母婴传播管理信息网络直报系统中的德宏州母婴阻断相关数据进行整理和分析。采用率和构成比对相关效果指标进行计算。结果2011—2013年期间，德宏州孕产妇人群的 HIV 检测率分别为99.2％（18694／18854）、99.9％（22047／22060）和99.9％（21751／21756），梅毒螺旋体检测率分别为56.0％（10550／18854）、99.6％（21980／22060）和99.9％（21751／21756），乙型肝炎病毒检测率分别为60.2％（11358／18854）、99.6％（21974／22060）和99.9％（21751／21756），3种病原体的检测率均逐年提高。2011—2013年，德宏州孕产妇HIV 阳性率为0.87％（327／37787）、0.82％（319／38817）和0.85％（315／37261）；梅毒螺旋体阳性率分别为0.05％（10／18520）、0.12％（43／36817）和0.11％（40／35888）；乙型肝炎阳性率分别为2.46％（456／18520）、2.23％（794／35547）和2.14％（739／34468）；HIV阳性产妇住院分娩率分别为99.2％（128／129）、100.0％（141／141）和100.0％（141／141）。2011—2013年，HIV阳性产妇接受预防性抗病毒治疗率分别为99.2％（128／129）、99.3％（140／141）和99.3％（140／141）；梅毒螺旋体阳性产妇治疗率分别为71％（5／7）、89％（16／18）和97％（32／33）；乙型肝炎病毒阳性产妇所生婴儿注射乙型肝炎免疫球蛋白率分别为92.9％（263／283）、99.7％（612／614）和99.4％（629／633）。3年间，估算的HIV母婴传播率分别为2.28％、2.30％和3.00％。结论2011—2013年期间，德宏州孕产妇人群HIV、梅毒螺旋体和乙型肝炎病毒的检测率逐年提高，HIV、梅毒螺旋体和乙型肝炎病毒的阳性展开更多
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
Chronic hepatitis B(CHB)is a significant public health problem worldwide.The aim of the present review is to summarize the actual trends in the management of CHB in pregnant women.The prevalence of hepatitis B virus(H...Chronic hepatitis B(CHB)is a significant public health problem worldwide.The aim of the present review is to summarize the actual trends in the management of CHB in pregnant women.The prevalence of hepatitis B virus(HBV)infection in pregnant women is usually comparable to that in the general population in the corresponding geographic area.All women have to be screened for hepatitis B surface antigen(HBsAg)during pregnancy.Additional examinations of pregnant women with CHB may include maternal hepatitis B e antigen,HBV viral load,alanine aminotransferase level,and HBsAg level.The management of pregnancy depends on the phase of the HBV infection,which has to be determined before pregnancy.In women of childbearing age with CHB,antiviral therapy can pursue two main goals:Treatment of active CHB,and vertical transmission prevention.During pregnancy,tenofovir is the drug of choice in both cases.A combination of hepatitis B immunoglobulin and vaccine against hepatitis B should be administered within the first 12 h to all infants born to mothers with CHB.In such cases,there are no contraindications to breastfeeding.展开更多
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
文摘HBV母婴传播是导致慢性HBV感染的主要原因,即HBV阳性孕妇在妊娠期或分娩过程中将HBV传染给新生儿。如果对HBV阳性母亲所生新生儿不采取任何免疫预防措施,70%-90%的新生儿会感染HBV,而新生儿一旦感染,90%以上会发展为慢性HBV感染[1-2]。自1992年我国开始将乙型肝炎疫苗（hepatitis B vaccine,HepB）纳入免疫规划管理,特别是自2002年HepB免费和2005年新生儿HepB接种完全免费以来,我国儿童和一般人群HBV感染率明显下降[3]。
文摘目的：了解云南省德宏州2011—2013年期间预防艾滋病、梅毒和乙型肝炎母婴传播的效果。方法通过收集2011—2013年德宏州预防艾滋病、梅毒和乙型肝炎母婴传播工作报表数据，并对国家艾滋病综合防治数据信息系统和预防艾滋病母婴传播管理信息网络直报系统中的德宏州母婴阻断相关数据进行整理和分析。采用率和构成比对相关效果指标进行计算。结果2011—2013年期间，德宏州孕产妇人群的 HIV 检测率分别为99.2％（18694／18854）、99.9％（22047／22060）和99.9％（21751／21756），梅毒螺旋体检测率分别为56.0％（10550／18854）、99.6％（21980／22060）和99.9％（21751／21756），乙型肝炎病毒检测率分别为60.2％（11358／18854）、99.6％（21974／22060）和99.9％（21751／21756），3种病原体的检测率均逐年提高。2011—2013年，德宏州孕产妇HIV 阳性率为0.87％（327／37787）、0.82％（319／38817）和0.85％（315／37261）；梅毒螺旋体阳性率分别为0.05％（10／18520）、0.12％（43／36817）和0.11％（40／35888）；乙型肝炎阳性率分别为2.46％（456／18520）、2.23％（794／35547）和2.14％（739／34468）；HIV阳性产妇住院分娩率分别为99.2％（128／129）、100.0％（141／141）和100.0％（141／141）。2011—2013年，HIV阳性产妇接受预防性抗病毒治疗率分别为99.2％（128／129）、99.3％（140／141）和99.3％（140／141）；梅毒螺旋体阳性产妇治疗率分别为71％（5／7）、89％（16／18）和97％（32／33）；乙型肝炎病毒阳性产妇所生婴儿注射乙型肝炎免疫球蛋白率分别为92.9％（263／283）、99.7％（612／614）和99.4％（629／633）。3年间，估算的HIV母婴传播率分别为2.28％、2.30％和3.00％。结论2011—2013年期间，德宏州孕产妇人群HIV、梅毒螺旋体和乙型肝炎病毒的检测率逐年提高，HIV、梅毒螺旋体和乙型肝炎病毒的阳性
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.
文摘Chronic hepatitis B(CHB)is a significant public health problem worldwide.The aim of the present review is to summarize the actual trends in the management of CHB in pregnant women.The prevalence of hepatitis B virus(HBV)infection in pregnant women is usually comparable to that in the general population in the corresponding geographic area.All women have to be screened for hepatitis B surface antigen(HBsAg)during pregnancy.Additional examinations of pregnant women with CHB may include maternal hepatitis B e antigen,HBV viral load,alanine aminotransferase level,and HBsAg level.The management of pregnancy depends on the phase of the HBV infection,which has to be determined before pregnancy.In women of childbearing age with CHB,antiviral therapy can pursue two main goals:Treatment of active CHB,and vertical transmission prevention.During pregnancy,tenofovir is the drug of choice in both cases.A combination of hepatitis B immunoglobulin and vaccine against hepatitis B should be administered within the first 12 h to all infants born to mothers with CHB.In such cases,there are no contraindications to breastfeeding.
