乙型肝炎病毒母婴传播预防临床指南(2020)

中华医学会妇产科学分会产科学组; 中华医学会围产医学分会

doi:10.3760/cma.j.cn112141-20200213-00101

乙型肝炎病毒母婴传播预防临床指南(2020)

DOI: 10.3760/cma.j.cn112141-20200213-00101

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中图分类号: R714.251
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出版历程
- 出版日期: 2020-07-20

2020 clinical guidelines on prevention of mother-to-child transmission of hepatitis B virus

Obstetrics Subgroup, Chinese Society of Obstetrics and Gynecology, Chinese Medical Association,
Chinese Society of Perinatal Medicine, Chinese Medical Association

摘要

摘要:
乙型肝炎病毒(HBV)母婴传播是我国慢性乙型肝炎(乙肝)的主要原因,预防HBV母婴传播是控制慢性乙肝的关键。本指南在《乙型肝炎病毒母婴传播预防临床指南(第1版)》基础上,更新了推荐建议,主要包括:(1)所有孕妇产前需筛查乙肝血清学指标;(2) HBsAg阴性母亲,其新生儿按"0、1、6月"方案接种乙肝疫苗,通常不需使用乙肝免疫球蛋白(HBIG);(3) HBsAg阳性母亲,其新生儿出生后12 h内(越快越好)肌内注射1针HBIG,并同时肌内注射第1针乙肝疫苗(越快越好),1月和6月龄分别接种第2针和第3针疫苗;(4)为进一步减少母婴传播,孕妇HBV DNA>2×10~5IU/ml或HBeAg阳性,从妊娠28～32周可开始服用抗病毒药物,分娩当日停药;(5)不推荐以减少HBV母婴传播为目的的剖宫产术。
- 乙型肝炎病毒 /
- 传染性疾病传播,垂直 /
- 免疫预防 /
- 诊疗准则(主题)
Abstract:
Mother-to-child transmission( MTCT) of hepatitis B virus( HBV) is the main cause of chronic hepatitis B( CHB) in China,and the prevention of MTCT plays a critical role in controlling CHB. Based on Clinical guidelines for the prevention of mother-to-child transmission of hepatitis B virus( First Edition) issued in 2013,the current clinical guidelines have updated the recommendations,mainly including:( 1) all pregnant women should undergo the prenatal screening for hepatitis B serological markers;( 2) neonates whose mothers have negative HBsAg should receive hepatitis B vaccination according to the regimen of “0,1,and 6 months”,and there is generally no need for hepatitis B immunoglobulin( HBIG);( 3) neonates whose mothers have positive HBsAg need intramuscular injection of HBIG at one dose and the first dose of hepatitis B vaccine within 12 hours after birth( the sooner the better),followed by injection of the second and third doses of hepatitis B vaccine at the age of 1 and 6 months,respectively;( 4) to further reduce MTCT of HBV,pregnant women with HBV DNA > 2 × 105 IU/ml or with positive HBe Ag may start to take oral antivirals at the 28-32 weeks of gestation until the day of delivery;( 5) cesarean section,with the purpose to reduce MTCT of HBV,is not recommended.
- hepatitis B virus /
- infectious disease transmission,vertical /
- immunoprophylaxis /
- practice guideline as topic

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参考文献(46)

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