摘要
乙型肝炎病毒（hepatitis B virus,HBV）主要经血、母婴及性接触传播[1]。母婴传播主要发生在围产期,多为在分娩时接触HBV阳性母亲的血液和体液传播。据报道,新生儿出生后若不及时采取免疫阻断措施,HBsAg单阳性母亲所生婴儿在围产期感染HBV的危险性为5%～20%,HBsAg和HBeAg双阳性母亲所生婴儿感染HBV的危险性可达70%～90%[2]。新生儿感染HBV后。
Perinatal transmission from mothers infected with HBV to their newborn infants is a major route of HBV infections in China.The risk of chronic HBV infection falls in a range of 70%-90% from mothers who are HBeAg-positive,and about 5%-20% from those who are HBeAg-negative.Previous studies have found that the blocking rate of mother-to-child transmission by hepatitis B vaccination is associated with the doses of hepatitis B vaccine（HepB）and/or hepatitis B immunoglobulin（HBIG）.Our study showed that the median level of HBV DNA in the HBeAg-positive pregnant women was significantly higher than that in the HBeAg-negative group（median 8.06 vs 2.57 lg IU/ml,P0.001）.The HBV protection rate of the infants immunized with HepB＋HBIG was significantly higher than that of those immunized with HepB alone.However,there was no significant difference between the 100 IU HBIG group and the 200 IU HBIG group.The geometric mean concentrations（GMC） of anti-HBs in infants immunized with 10 μg Hansenula recombinant HepB（H-HepB） was higher than that in those accepted 5 μg Saccharomyces cerevisiae recombinant HepB（S-HepB）.Moreover,the non/low-response rate of anti-HBs in the 10 μg H-HepB group was much lower than that in the 5 μg S-HepB or 10 μg S-HepB group.Within groups that were administered the same kinds of HepB,the higher the dose,the higher rate of anti-HBs response.Follow-up results of 7-month old infants showed that the HBsAg-positive rates were strongly correlated with the HBeAg status of their mothers,the HBeAg-positive mothers are more likely corresponding to failed prevention in their infants（higher HBsAg-positive rate） comparing to HBeAg-negative mothers.Therefore,HepB immunization strategy for newborns should be further optimized.We have recommended the increase of HepB dose from 5 μg to 10 μg,and the implementation of combined HepB＋HBIG for all neonates whose mothers are positive in both HBsAg and HBeAg.
出处
《中国病毒病杂志》
CAS
2012年第1期1-3,共3页
Chinese Journal of Viral Diseases
基金
国家"十一五"艾滋病和病毒性肝炎等重大传染病防治科技重大专项(2008ZX10002-001)
关键词
病毒性肝炎
乙型
乙型肝炎病毒
疫苗
预防
Viral hepatitis
type B
Hepatitis B virus
Vaccine
Prevention
