我国消除HBV母婴传播的实施案例与经验介绍

罗雅丽; 王维; 潘禹辰; 姜晶; 郑寒龙; 吴雪丽; 陈慧; 朱世奔; 侯金林

doi:10.12449/JCH241103

我国消除HBV母婴传播的实施案例与经验介绍

DOI: 10.12449/JCH241103

罗雅丽¹,
王维¹,
潘禹辰²,
姜晶²,
郑寒龙³,
吴雪丽³,
陈慧⁴,
朱世奔⁵,
侯金林^5, , ,

1.
深圳市宝安区妇幼保健院保健部，广东深圳 518100
2.
吉林大学第一医院临床流行病学研究室，长春 130021
3.
佛山市妇幼保健院保健部，广东佛山 528000
4.
吉林省肝胆病医院肝病内科，长春 130062
5.
南方医科大学南方医院感染内科暨肝病中心，广州 510515

基金项目:

国家重点研发计划 (2022YFC2303600)

利益冲突声明：本文不存在任何利益冲突。

作者贡献声明：罗雅丽、潘禹辰、郑寒龙、陈慧负责文章撰写；王维、姜晶、吴雪丽负责审核文章；朱世奔负责整理；侯金林负责终审并最终定稿。罗雅丽、潘禹辰、郑寒龙、陈慧对本文贡献等同，同为第一作者。

详细信息

通信作者:
侯金林， jlhousmu@163.com （ORCID： 0000-0001-8230-8583）

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出版历程
- 收稿日期: 2024-09-02
- 录用日期: 2024-10-10
- 出版日期: 2024-11-25

Experience in eliminating the mother-to-child transmission of hepatitis B virus in China

1.
Department of Healthcare，Maternal and Child Health Hospital of Bao’an District，Shenzhen，Guangdong 518100，China
2.
Clinical Epidemiology Laboratory，The First Hospital of Jilin University，Changchun 130021，China
3.
Department of Healthcare，Foshan Maternal and Child Health Hospital，Foshan，Guangdong 528000，China
4.
Department of Hepatology，Hepatobiliary Hospital of Jilin，Changchun 130062，China
5.
Department of Infectious Diseases and Hepatology Unit，Nanfang Hospital，Southern Medical University，Guangzhou 510515，China

Research funding:

National Key Research and Development Program of China (2022YFC2303600)

摘要

摘要: HBV母婴传播的减少是实现消除HBV的关键步骤。“乙肝母婴零传播工程”（“小贝壳”项目）于2015年7月在北京人民大会堂正式启动，是集科学防治和应用性研究于一体的公益项目，目的是通过移动医疗工具“小贝壳”手机应用软件对乙型肝炎孕妇进行规范化管理，以进一步减少甚至消除HBV母婴传播。目前，“小贝壳”项目已覆盖全国，为阻断HBV母婴传播提供了详细的实施策略、成功的实践经验及可靠的数据支持，对全球实现消除HBV母婴传播具有重要价值。本文详细介绍了4个典型案例的“小贝壳”项目实施策略及其成效，为进一步理解和阻断母婴传播提供了有力证据。
- 乙型肝炎病毒 /
- 传染性疾病传播，垂直 /
- “小贝壳”项目
Abstract: Reducing the mother-to-child transmission of hepatitis B virus （HBV） is crucial for achieving HBV elimination. Launched in July 2015 at the Great Hall of the People in Beijing， China， the “Zero Hepatitis B Mother-to-Child Transmission Project” （Shield Project） is a public welfare initiative integrating scientific prevention and applied research and aims to perform standardized management of pregnant women with hepatitis B using the mobile application of “Shield Project”， in order to further reduce or eliminate the mother-to-child transmission of HBV. At present， the Shield Project has expanded nationwide， offering detailed implementation strategies， successful practices， and reliable data to support the global effort to eliminate the mother-to-child transmission of HBV. This article introduces the implementation strategies and outcomes of the Shield Project in four representative cases， in order to provide strong evidence for further understanding and preventing the mother-to-child transmission of HBV.
- Hepatitis B Virus /
- Infectious Diseases Transmission， Vertical /
- “Shield” Program

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参考文献(33)

[1]	World Health Organization. Prevention of mother-to-child transmission of hepatitis B virus: guidelines on antiviral prophylaxis in pregnancy[R]. Geneva: World Health Organization, 2020.
[2]	World Health Organization. Guidelines for the prevention, care and treatment of persons with chronic hepatitis B infection[R]. Geneva: World Health Organization, 2015.
[3]	WANG GQ, DUAN ZP. Guidelines for prevention and treatment of chronic hepatitis B[J]. J Clin Transl Hepatol, 2021, 9( 5): 769- 791. DOI: 10.14218/JCTH.2021.00209.
[4]	CUI FQ, WOODRING J, CHAN PL, et al. Considerations of antiviral treatment to interrupt mother-to-child transmission of hepatitis B virus in China[J]. Int J Epidemiol, 2018, 47( 5): 1529- 1537. DOI: 10.1093/ije/dyy077.
[5]	World Health Organization. Global health sector strategy on viral hepatitis 2016-2021. Towards ending viral hepatitis[R]. World Health Organization, 2016.
[6]	COOKE GS, ANDRIEUX-MEYER I, APPLEGATE TL, et al. Accelerating the elimination of viral hepatitis: A lancet gastroenterology& hepatology commission[J]. Lancet Gastroenterol Hepatol, 2019, 4( 2): 135- 184. DOI: 10.1016/S2468-1253(18)30270-X.
[7]	CHEN HL, LIN LH, HU FC, et al. Effects of maternal screening and universal immunization to prevent mother-to-infant transmission of HBV[J]. Gastroenterology, 2012, 142( 4): 773- 781. e 2. DOI: 10.1053/j.gastro.2011.12.035.
[8]	CHEN HL, LEE CN, CHANG CH, et al. Efficacy of maternal tenofovir disoproxil fumarate in interrupting mother-to-infant transmission of hepatitis B virus[J]. Hepatology, 2015, 62( 2): 375- 386. DOI: 10.1002/hep.27837.
[9]	PAN CQ, DUAN ZP, DAI EH, et al. Tenofovir to prevent hepatitis B transmission in mothers with high viral load[J]. N Engl J Med, 2016, 374( 24): 2324- 2334. DOI: 10.1056/NEJMoa1508660.
[10]	HYUN MH, LEE YS, KIM JH, et al. Systematic review with meta-analysis: The efficacy and safety of tenofovir to prevent mother-to-child transmission of hepatitis B virus[J]. Aliment Pharmacol Ther, 2017, 45( 12): 1493- 1505. DOI: 10.1111/apt.14068.
[11]	de VILLIERS MJ, NAYAGAM S, HALLETT TB. The impact of the timely birth dose vaccine on the global elimination of hepatitis B[J]. Nat Commun, 2021, 12( 1): 6223. DOI: 10.1038/s41467-021-26475-6.
[12]	SU WJ, CHEN SF, YANG CH, et al. The impact of universal infant hepatitis B immunization on reducing the hepatitis B carrier rate in pregnant women[J]. J Infect Dis, 2019, 220( 7): 1118- 1126. DOI: 10.1093/infdis/jiy706.
[13]	FAN R, YIN XR, LIU ZH, et al. A hepatitis B-free generation in China: From dream to reality[J]. Lancet Infect Dis, 2016, 16( 10): 1103- 1105. DOI: 10.1016/S1473-3099(16)30327-9.
[14]	YIN XR, HAN GR, ZHANG H, et al. A real-world prospective study of mother-to-child transmission of HBV in China using a mobile health application(shield 01)[J]. J Clin Transl Hepatol, 2020, 8( 1): 1- 8. DOI: 10.14218/JCTH.2019.00057.
[15]	HOU JL, CUI FQ, DING Y, et al. Management algorithm for interrupting mother-to-child transmission of hepatitis B virus[J]. Clin Gastroenterol Hepatol, 2019, 17( 10): 1929- 1936.e1. DOI: 10.1016/j.cgh.2018.10.007.
[16]	LIU J, WANG XY, WANG Q, et al. Hepatitis B virus infection among 90 million pregnant women in 2853 Chinese Counties, 2015-2020: A national observational study[J]. Lancet Reg Health West Pac, 2021, 16: 100267. DOI: 10.1016/j.lanwpc.2021.100267.
[17]	Chinese Foundation for Hepatitis Prevention and Control; Chinese Society of Infectious Diseases, Chinese Medical Association; Chinese Society of Hepatology, Chinese Medical Association. Management algorithm for interrupting mother-to-child transmission of hepatitis B virus(2021)[J]. J Clin Hepatol, 2021, 37( 3): 527- 531. DOI: 10.3969/j.issn.1001-5256.2021.03.007. 中国肝炎防治基金会, 中华医学会感染病学分会, 中华医学会肝病学分会. 阻断乙型肝炎病毒母婴传播临床管理流程(2021年)[J]. 临床肝胆病杂志, 2021, 37( 3): 527- 531. DOI: 10.3969/j.issn.1001-5256.2021.03.007.
[18]	ZHANG X, YU Y, YANG HJ, et al. Surveillance of maternal syphilis in China: Pregnancy outcomes and determinants of congenital syphilis[J]. Med Sci Monit, 2018, 24: 7727- 7735. DOI: 10.12659/MSM.910216.
[19]	Chinese Foundation for Hepatitis Prevention and Control; Chinese Society of Infectious Diseases, Chinese Medical Association; Chinese Society of Hepatology, Chinese Medical Association. Management algorithm for interrupting mother-to-child transmission of hepatitis B[J]. J Clin Hepatol, 2017, 33( 7): 1214- 1217. DOI: 10.3969/j.issn.1001-5256.2017.07.003. 中国肝炎防治基金会, 中华医学会感染病学分会, 中华医学会肝病学分会. 乙型肝炎母婴阻断临床管理流程[J]. 临床肝胆病杂志, 2017, 33( 7): 1214- 1217. DOI: 10.3969/j.issn.1001-5256.2017.07.003.
[20]	LUO YL, GAO S, ZHANG QF, et al. Eliminating mother-to-child transmission of hepatitis B virus: Practice and progress in baoan, a national pilot district of China[J]. BMC Public Health, 2024, 24( 1): 58. DOI: 10.1186/s12889-023-17500-y.
[21]	Guangdong Provincial Health Commission. Guangdong Provincial Health Commission Office on the issuance of“Guangdong Province to eliminate AIDS, syphilis and hepatitis B mother-to-child transmission action plan( 2023— 2025)”[EB/OL].( 2023-02-17). https://wsjkw.gd.gov.cn/zwyw_bmwj/content/post_4097111.html. https://wsjkw.gd.gov.cn/zwyw_bmwj/content/post_4097111.html 广东省卫生健康委. 广东省卫生健康委办公室关于印发《广东省消除艾滋病、梅毒和乙肝母婴传播行动计划(2023—2025年)》的通知[EB/OL].( 2023-02-17). https://wsjkw.gd.gov.cn/zwyw_bmwj/content/post_4097111.html. https://wsjkw.gd.gov.cn/zwyw_bmwj/content/post_4097111.html
[22]	ZENG Y. Changchun: Free medical treatment for pregnant women with hepatitis B to give birth to a healthy baby[N/OL]. Bright Daily, 2012-07-04. https://epaper.gmw.cn/gmrb/html/2012-07/04/nw.D110000gmrb_20120704_5-09.htm?div=-1. https://epaper.gmw.cn/gmrb/html/2012-07/04/nw.D110000gmrb_20120704_5-09.htm?div=-1 曾毅. 长春: 免费医疗让乙肝孕妇生出健康宝宝[N/OL]. 光明日报, 2012-07-04. https://epaper.gmw.cn/gmrb/html/2012-07/04/nw.D110000gmrb_20120704_5-09.htm?div=-1. https://epaper.gmw.cn/gmrb/html/2012-07/04/nw.D110000gmrb_20120704_5-09.htm?div=-1
[23]	EDMUNDS WJ, MEDLEY GF, NOKES DJ, et al. The influence of age on the development of the hepatitis B carrier state[J]. Proc Biol Sci, 1993, 253( 1337): 197- 201. DOI: 10.1098/rspb.1993.0102.
[24]	Chinese Society of Hepatology and Chinese Society of Infectious Diseases, Chinese Medical Association. The guideline of prevention and treatment for chronic hepatitis B(2010 version)[J]. J Clin Hepatol, 2011, 27( 1): 113- 128. 中华医学会肝病学分会, 中华医学会感染病学分会. 慢性乙型肝炎防治指南(2010年版)[J]. 临床肝胆病杂志, 2011, 27( 1): 113- 128.
[25]	Chinese Society of Hepatology and Chinese Society of Infectious Diseases, Chinese Medical Association. The guideline of prevention and treatment for chronic hepatitis B: a 2015 update[J]. J Clin Hepatol, 2015, 31( 12): 1941- 1960. DOI: 10.3969/j.issn.1001-5256.2015.12.002. 中华医学会肝病学分会, 中华医学会感染病学分会. 慢性乙型肝炎防治指南(2015年更新版)[J]. 临床肝胆病杂志, 2015, 31( 12): 1941- 1960. DOI: 10.3969/j.issn.1001-5256.2015.12.002.
[26]	PAN YC, JIA ZF, WANG YQ, et al. The role of Caesarean section and nonbreastfeeding in preventing mother-to-child transmission of hepatitis B virus in HBsAg-and HBeAg-positive mothers: Results from a prospective cohort study and a meta-analysis[J]. J Viral Hepat, 2020, 27( 10): 1032- 1043. DOI: 10.1111/jvh.13314.
[27]	WANG C, WANG C, JIA ZF, et al. Protective effect of an improved immunization practice of mother-to-infant transmission of hepatitis B virus and risk factors associated with immunoprophylaxis failure[J]. Medicine(Baltimore), 2016, 95( 34): e4390. DOI: 10.1097/MD.0000000000004390.
[28]	PAN YC, WANG C, WEN SM, et al. Clinical effect and short-term safety of telbivudine in blocking mother-to-child transmission of HBV[J]. J Clin Hepatol, 2017, 33( 9): 1707- 1712. DOI: 10.3969/j.issn.1001-5256.2017.09.015. 潘禹辰, 王崇, 文思敏, 等. 替比夫定阻断HBV母婴传播的效果和短期安全性[J]. 临床肝胆病杂志, 2017, 33( 9): 1707- 1712. DOI: 10.3969/j.issn.1001-5256.2017.09.015.
[29]	Publication WHO. Hepatitis B vaccines: WHO position paper--recommendations[J]. Vaccine, 2010, 28( 3): 589- 590. DOI: 10.1016/j.vaccine.2009.10.110.
[30]	LIANG Y, LIN HL, WU XL, et al. Preventive effect of full and standardized hepatitis B vaccination on mother-to-infant transmission[J]. Modern Prevent Med, 2021, 48( 4): 654- 657, 723. 梁颖, 林华亮, 吴雪丽, 等. 乙肝疫苗全程及规范接种对HBV母婴阻断效果的影响[J]. 现代预防医学, 2021, 48( 4): 654- 657, 723.
[31]	National Health and Family Planning Commission. Notice of the National Health and Family Planning Commission on Issuing the“National Basic Public Health Service Standards(Third Edition)”[EB/OL].( 2017-03-28). http://www.nhc.gov.cn/jws/s3578/201703/d20c37e23e1f4c7db7b8e25f34473e1b.shtml. http://www.nhc.gov.cn/jws/s3578/201703/d20c37e23e1f4c7db7b8e25f34473e1b.shtml 国家卫生计生委. 国家卫生计生委关于印发《国家基本公共卫生服务规范(第三版)》的通知[EB/OL].( 2017-03-28). http://www.nhc.gov.cn/jws/s3578/201703/d20c37e23e1f4c7db7b8e25f34473e1b.shtml. http://www.nhc.gov.cn/jws/s3578/201703/d20c37e23e1f4c7db7b8e25f34473e1b.shtml
[32]	National Health Commission. Notice of the National Health Commission of the People’s Republic of China on issuing the national immunization program vaccine immunization procedures and instructions for children(2021 edition)[EB/OL].( 2021-02-23). http://www.nhc.gov.cn/jkj/s3581/202103/590a8c7915054aa682a8d2ae8199e222.shtml. http://www.nhc.gov.cn/jkj/s3581/202103/590a8c7915054aa682a8d2ae8199e222.shtml 国家卫生健康委. 国家卫生健康委关于印发国家免疫规划疫苗儿童免疫程序及说明(2021年版)的通知[EB/OL].( 2021-02-23). http://www.nhc.gov.cn/jkj/s3581/202103/590a8c7915054aa682a8d2ae8199e222.shtml. http://www.nhc.gov.cn/jkj/s3581/202103/590a8c7915054aa682a8d2ae8199e222.shtml
[33]	WANG RH, BAO Z, HU Y. Analysis of influencing factors of post-vaccination serologic testing in children exposed to hepatitis B virus in Tongzhou District, Beijing from 2020 to 2022[J]. Shanghai J Prev Med, 2024, 36( 5): 423- 428. DOI: 10.19428/j.cnki.sjpm.2024.23495. 王荣环, 鲍筝, 胡月. 2020—2022年北京市通州区乙型肝炎病毒暴露儿童免疫后血清学检测影响因素分析[J]. 上海预防医学, 2024, 36( 5): 423- 428. DOI: 10.19428/j.cnki.sjpm.2024.23495.