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

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

Volume 36 Issue 7

Jul. 2020

Turn off MathJax

Article Contents

Abstract

References

Article Navigation > Journal of Clinical Hepatology > 2020 > 36(7): 1474-1481

PDF( 309 KB)

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

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

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

Published Date: 2020-07-20

Abstract

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

FullText(HTML)

References(46)

References

[1] Obstetrics Subgroup,Chinese Society of Obstetrics and Gynecology,Chinese Medical Association.Clinical guidelines for the prevention of mother-to-child transmission of hepatitis B virus(First Edition)[J].Chin J Obstetr Gynecol,2013,48(2):151-154.(in Chinese)中华医学会妇产科学分会产科学组．乙型肝炎病毒母婴传播预防临床指南(第1版)[J]．中华妇产科杂志，2013,48(2):151-154．

[2]XU CY,LIU JL,LIU LH,et al.Levels of hepatitis B virus and its antigen in pregnant versus non-pregnant women of childbearing age[J].Chin J Perinatal Med,2015,18(11):828-831.(in Chinese)徐陈瑜，刘景丽，刘兰华，等．妊娠和非妊娠育龄妇女体内乙型肝炎病毒及其抗原水平比较[J]．中华围产医学杂志，2015,18(11):828-831．

[3]LU Y,ZHU FC,LIU JX,et al.The maternal viral threshold for antiviral prophylaxis of perinatal hepatitis B virus transmission in settings with limited resources:A large prospective cohort study in China[J].Vaccine,2017,35(48 Pt B):6627-6633．

[4]LIU JL,LIU LH,XU CY,et al.Limitation of hepatitis B markers in cord blood for diagnosing intrauterine infection of hepatitis B virus[J].Chin J Perinatal Med,2015,18(11):812-817.(in Chinese)刘景丽，刘兰华，徐陈瑜，等．脐血乙型肝炎病毒血清学标记物诊断宫内感染的局限性[J]．中华围产医学杂志，2015,18(11):812-817．

[5]ZHANG L,GUI XE,WANG B,et al.Serological positive markers of hepatitis B virus in femoral venous blood or umbilical cord blood should not be evidence of in-utero infection among neonates[J].BMC Infect Dis,2016,16(1):408．

[6]LIU J,XU B,CHEN T,et al.Presence of hepatitis B virus markers in umbilical cord blood:Exposure to or infection with the virus?[J].Dig Liver Dis,2019,51(6):864-869．

[7]WANG L,KOURTIS AP,ELLINGTON S,et al.Safety of tenofovir during pregnancy for the mother and fetus:A systematic review[J].Clin Infect Dis,2013,57(12):1773-1781．

[8]GILES M,VISVANATHAN K,LEWIN S,et al.Clinical and virological predictors of hepatic flares in pregnant women with chronic hepatitis B[J].Gut,2015,64(11):1810-1815．

[9]YI W,PAN CQ,HAO J,et al.Risk of vertical transmission of hepatitis B after amniocentesis in HBs antigen-positive mothers[J].JHepatol,2014,60(3):523-529．

[10]HAN Z,ZHANG Y,BAI X,et al.Mother-to-child transmission of hepatitis B virus after amniocentesis:A retrospective matched cohort study[J].Prenat Diagn,2019,39(6):431-440．

[11]ZHU YY,MAO YZ,WU WL,et al.Does hepatitis B virus prenatal transmission result in postnatal immunoprophylaxis failure?[J].Clin Vaccine Immunol,2010,17(12):1836-1841．

[12]FENG J,LI J,LIU JL,et al.Influence of amniocentesis on risk of mother-to-child transmission of hepatitis B virus[J].Chin J Perinatal Med,2015,18(11):823-827.(in Chinese)冯静，李洁，刘景丽，等．羊膜腔穿刺对乙型肝炎病毒母婴传播的影响[J]．中华围产医学杂志，2015,18(11):823-827．

[13]HU Y,XU C,XU B,et al.Safety and efficacy of telbivudine in late pregnancy to prevent mother-to-child transmission of hepatitis B virus:A multicenter prospective cohort study[J].J Viral Hepat,2018,25(4):429-437．

[14]JOURDAIN G,NGO-GIANG-HUONG N,HARRISON L,et al.Tenofovir versus placebo to prevent perinatal transmission of hepatitis B[J].N Engl J Med,2018,378(10):911-923．

[15]ZHANG H,PAN CQ,PANG Q,et al.Telbivudine or lamivudine use in late pregnancy safely reduces perinatal transmission of hepatitis Bvirus in real-life practice[J].Hepatology,2014,60(2):468-476．

[16]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．

[17]PAN CQ,DUAN Z,DAI E,et al.Tenofovir to prevent hepatitis Btransmission in mothers with high viral load[J].N Engl J Med,2016,374(24):2324-2334．

[18]ZENG QL,XU GH,WANG B,et al.Prophylactic antiviral therapy for the prevention of mother-to-child transmission of hepatitis B virus can be stopped at delivery[J].J Viral Hepat,2018,25(5):612-613．

[19]GREENUP AJ,TAN PK,NGUYEN V,et al.Efficacy and safety of tenofovir disoproxil fumarate in pregnancy to prevent perinatal transmission of hepatitis B virus[J].J Hepatol,2014,61(3):502-507．

[20]ZHOU YH,HU YL.Prevention of mother-to-infant transmission of hepatitis B:Advances and challenges[J].Chin J Perinatal Med,2018,21(8):505-509.(in Chinese)周乙华，胡娅莉．我国预防乙型肝炎母婴传播的进展和亟待研究的问题[J]．中华围产医学杂志，2018,21(8):505-509．

[21]European Association for the Study of the Liver.EASL 2017 clinical practice guidelines on the management of hepatitis B virus infection[J].J Hepatol,2017,67(2):370-398．

[22]TERRAULT NA,LOK ASF,Mc MAHON BJ,et al.Update on prevention,diagnosis,and treatment of chronic hepatitis B:AASLD 2018hepatitis B guidance[J].Hepatology,2018,67(4):1560-1599．

[23]CUI FQ,ZHUANG H.Achievements and prospects for preventing mother-to-child transmission of hepatitis B virus in newborns in China[J].Chin J Viral Dis,2019,9(5):321-326.(in Chinese)崔富强，庄辉．我国新生儿乙型肝炎母婴阻断成就和展望[J]．中国病毒病杂志，2019,9(5):321-326．

[24] Chinese Society of Infectious Diseases,Chinese Medical Association;Chinese Society of Hepatology,Chinese Medical Association.Guidelines for the prevention and treatment of chronic hepatitis B(version2019)[J].J Clin Hepatol,2019,35(12):2648-2669.(in Chinese)中华医学会感染病学分会，中华医学会肝病学分会．慢性乙型肝炎防治指南(2019年版)[J]．临床肝胆病杂志，2019,35(12):2648-2669．

[25]CHEUNG KW,SETO M,KAN A,et al.Immunoprophylaxis failure of infants born to hepatitis B carrier mothers following routine vaccination[J].Clin Gastroenterol Hepatol,2018,16(1):144-145．

[26]LOU HQ,ZHU JH,WANG ZH,et al.Real-world efficacy of immunoprophylaxis against mother-to-infant transmission of hepatitis B virus based on puerperant population[J].Chin J Perinatal Med,2019,22(8):591-596.(in Chinese)娄海琴，朱继华，王志红，等．以产妇人群为基础的免疫预防乙型肝炎病毒母婴传播的现实世界效果[J]．中华围产医学杂志，2019,22(8):591-596．

[27]QIAO YP,SU M,SONG Y,et al.Outcomes of the national programme on prevention of mother-to-child transmission of hepatitis Bvirus in China,2016-2017[J].Infect Dis Poverty,2019,8(1):65．

[28]ZHOU YH.Issues meriting further study in preventing mother-to-infant transmission of hepatitis B by antiviral therapy during pregnancy[J].Maternal Fetal Medicine,2019,1(1):43-47．

[29]LIN XQ,HU YL,ZHOU YH.Efficacy and adverse events of nucleos(t)ide analogues in the prevention of perinatal transmission of hepatitis B during pregnancy[J].Chin J Viral Dis,2015,5(3):161-166.(in Chinese)林晓倩，胡娅莉，周乙华．孕期使用核苷(酸)类药物预防乙型肝炎病毒母婴传播的效果和不良事件[J]．中国病毒病杂志，2015,5(3):161-166．

[30]HAN GR,JIANG HX,WANG CM,et al.Long-term safety and efficacy of telbivudine in infants born to mothers treated during the second or third trimesters of pregnancy[J].J Viral Hepat,2017,24(6):514-521．

[31]CHEN ZX,GU GF,BIAN ZL,et al.Clinical course and perinatal transmission of chronic hepatitis B during pregnancy:A real-world prospective cohort study[J].J Infect,2017,75(2):146-154．

[32]WANG R,FANG S,SUN Q,et al.Congenital biliary atresia in an infant born to hepatitis B mother treated with telbivudine before and during pregnancy[J].Dig Liver Dis,2018,50(10):1097-1098．

[33]HE T,BAI Y,CAI H,et al.Safety and efficacy of lamivudine or telbivudine started in early pregnancy for mothers with active chronic hepatitis B[J].Hepatol Int,2018,12(2):118-125．

[34]ZHOU C,YU Y,YANG Q,et al.Motor development delay in offspring is associated with prenatal telbivudine exposure[J].Medicine(Baltimore),2018,97(9):e0053．

[35]KOURTIS AP,WIENER J,WANG L,et al.Tenofovir disoproxil fumarate use during pregnancy and infant bone health:The Tenofovir in pregnancy pilot study[J].Pediatr Infect Dis J,2018,37(11):e264-e268．

[36]PAN CQ,ZOU HB,CHEN Y,et al.Cesarean section reduces perinatal transmission of hepatitis B virus infection from hepatitis B surface antigen-positive women to their infants[J].Clin Gastroenterol Hepatol,2013,11(10):1349-1355．

[37]HU Y,CHEN J,WEN J,et al.Effect of elective cesarean section on the risk of mother-to-child transmission of hepatitis B virus[J].BMC Pregnancy Childbirth,2013,13:119．

[38]CHEN HL,CAI JY,SONG YP,et al.Vaginal delivery and HBVmother to child transmission risk after immunoprophylaxis:A systematic review and a meta-analysis[J].Midwifery,2019,74:116-125．

[39]BRUCE MG,BRUDEN D,HURLBURT D,et al.Antibody levels and protection after hepatitis B vaccine:Results of a 30-year follow-up study and response to a booster dose[J].J Infect Dis,2016,214(1):16-22．

[40]SIMONS BC,SPRADLING PR,BRUDEN DJ,et al.A longitudinal hepatitis B vaccine cohort demonstrates long-lasting hepatitis B virus(HBV)cellular immunity despite loss of antibody against HBV surface antigen[J].J Infect Dis,2016,214(2):273-280．

[41]WEI KP,ZHU FC,LIU JX,et al.The efficacy of two different dosages of hepatitis B immunoglobulin combined with hepatitis B vaccine in preventing mother-to-child transmission of hepatitis B virus:Aprospective cohort study[J].Vaccine,2018,36(2):256-263．

[42]Are booster immunisations needed for lifelong hepatitis B immunity?European Consensus Group on Hepatitis B Immunity[J].Lancet,2000,355(9203):561-565．

[43]ZHAO H,ZHOU YH.Revaccination against hepatitis B in late teenagers who received vaccination during infancy:Yes or no?[J].Hum Vaccin Immunother,2018,14(2):456-463．

[44]ZHOU YH,HU YL.An appropriate dose of hepatitis B immunoglobulin for preventing mother-to-child transmission of hepatitis B:Asingle injection of 100 U[J].Chin J Perinatal Med,2018,21(2):109-111.(in Chinese)周乙华，胡娅莉．预防乙型肝炎母婴传播的乙肝免疫球蛋白合理剂量:100U单次注射[J]．中华围产医学杂志，2018,21(2):109-111．

[45]LIU JL,FENG J,LIN XQ,et al.Characterization of binding capability of human breast milk to hepatitis B surface antigen[J].Chin JPerinatal Med,2016,19(2):114-118.(in Chinese)刘景丽，冯静，林晓倩，等．母乳与乙型肝炎表面抗原的结合特性[J]．中华围产医学杂志，2016,19(2):114-118．

[46]ZHANG SP,LIU JL,FENG J,et al.Screening and identification of hepatitis B surface antigen binding to lactoferrin in human milk[J].Chin J Perinatal Med,2019,22(7):457-460.(in Chinese)张昭萍，刘景丽，冯静，等．乙型肝炎表面抗原结合人乳中乳铁蛋白的筛选与鉴定[J]．中华围产医学杂志，2019,22(7):457-460.

Relative Articles

[1]	Xin LIU, Jia LI, Fengmin LU. The way is simple： A brief natural history of chronic hepatitis B virus infection and disease progression[J]. Journal of Clinical Hepatology, 2024, 40(9): 1741-1745. doi: 10.12449/JCH240905
[2]	Society of Prevention and Control of Infectious Diseases of Chinese Preventive Medicine Association, Working Committee of Promoting the Elimination of Viral Hepatitis of Chinese Preventive Medicine Association. Expert recommendations on screening， testing and management for hepatitis B virus infection in adults[J]. Journal of Clinical Hepatology, 2024, 40(8): 1543-1550. doi: 10.12449/JCH240807
[3]	Infectious Diseases Physicians Branch， Chinese Medical Doctor Association, Chinese Society of Infectious Diseases， Chinese Medical Association. Chinese practice guideline for the prevention and treatment of mother-to-child transmission of hepatitis B virus （version 2024）[J]. Journal of Clinical Hepatology, 2024, 40(8): 1557-1566. doi: 10.12449/JCH240809
[4]	Shan ZHANG, Dong JI, Guofeng CHEN. An excerpt of APASL clinical practice guideline on hepatitis B reactivation related to the use of immunosuppressive therapy (2021)[J]. Journal of Clinical Hepatology, 2021, 37(12): 2782-2786. doi: 10.3969/j.issn.1001-5256.2021.12.010
[5]	Xian JianChun, Zhou YiHua. Comments on the recommendations for unintended pregnancy during antiviral therapy in women of childbearing age in 2019 Chinese practice guideline for the prevention and treatment of hepatitis B virus mother-to-child transmission[J]. Journal of Clinical Hepatology, 2020, 36(2): 301-302. doi: 10.3969/j.issn.1001-5256.2020.02.010
[6]	Ding Yang, Dou XiaoGuang. A second discussion on 2019 Chinese practice guideline for the prevention and treatment of hepatitis B virus motherto-child transmission: Evidence,evidence,and always evidence[J]. Journal of Clinical Hepatology, 2020, 36(2): 303-304. doi: 10.3969/j.issn.1001-5256.2020.02.011
[7]	Wang DeYang. Several opinions on 2019 Chinese practice guideline for the prevention and treatment of hepatitis B virus mother-to-child transmission[J]. Journal of Clinical Hepatology, 2020, 36(2): 307-307. doi: 10.3969/j.issn.1001-5256.2020.02.013
[8]	Zhou YiHua, Li Tong, Zhuang Hui. Comments on “2019 Chinese practice guideline for the prevention and treatment of hepatitis B virus mother-to-child transmission”[J]. Journal of Clinical Hepatology, 2020, 36(1): 59-61. doi: 10.3969/j.issn.1001-5256.2020.01.013
[9]	Cui FuQiang. Hepatitis B vaccine immunization is the key strategy for prevention of HBV mother-to-child transmission——Comments on 2019 Chinese practice guideline for the prevention and treatment of hepatitis B virus mother-to-child transmission[J]. Journal of Clinical Hepatology, 2020, 36(2): 305-306. doi: 10.3969/j.issn.1001-5256.2020.02.012
[10]	Liu JinFeng, Chen TianYan, Chen YaoLong, Zhao YingRen. Response to the article of “comments on 2019 Chinese practice for the prevention and treatment of hepatitis B virus mother-to-child transmission”[J]. Journal of Clinical Hepatology, 2020, 36(1): 62-64. doi: 10.3969/j.issn.1001-5256.2020.01.014
[11]	Yin XueRu, She GeXin, Hou JinLin, Fan Rong. Clinical significance and application of quantification of hepatitis B core antibody[J]. Journal of Clinical Hepatology, 2019, 35(10): 2156-2158. doi: 10.3969/j.issn.1001-5256.2019.10.005
[12]	Chinese Society of Organ Transplantation, Chinese Medical Association. Diagnosis and treatment standard for hepatitis B virus infection after organ transplantation (2019 edition)[J]. Journal of Clinical Hepatology, 2019, 35(9): 1924-1927. doi: 10.3969/j.issn.1001-5256.2019.09.007
[13]	Zhao Fei, Liu Fei, Wang ZhongFeng, Li HaiJun, Xu HongMei. Vertical transmission of hepatitis B virus: Modes and blocking strategies[J]. Journal of Clinical Hepatology, 2019, 35(11): 2557-2560. doi: 10.3969/j.issn.1001-5256.2019.11.037
[14]	Hou YuanPei, Liu ChengYong, Gao YuJin. Affection of the mutations and genotypes of hepatitis B virus precore and basic core promoter on HBeAg expression[J]. Journal of Clinical Hepatology, 2007, 23(4): 251-253.
[15]	Xie Fang, Lin ZunHui, Jin HaiYing, Guo XiangHua, Huang YanXiang, Yin JiMing, Yan Yan, Hao Wa, Niu JingQin, Li Zhuo. The applied value of Dane granule antigen of hepatitis B viral in detecting chronic hepatitis B infection[J]. Journal of Clinical Hepatology, 2007, 23(6): 415-417.
[16]	Liu ChengYong, Hou YuanPei, Qian XiuMei, Sun Qing, Song Li. Distribution of hepatitis B virus genotype in Xuzhou and its clinical significance[J]. Journal of Clinical Hepatology, 2005, 21(3): 151-152.

Supplements(0)

Cited By

Proportional views

Proportional views

通讯作者: 陈斌, bchen63@163.com

1.
沈阳化工大学材料科学与工程学院沈阳 110142

Get Citation

PDF

XML

Article Metrics

Article views (923) PDF downloads(870)

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

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

Abstract

References

Relative Articles

Proportional views

Catalog

通讯作者: 陈斌, bchen63@163.com

Article Metrics

Proportional views

Related

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

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

Abstract

References

Relative Articles

Proportional views

Catalog

通讯作者: 陈斌, bchen63@163.com

Article Metrics

Proportional views

Related

About Journal

Submission Guideline

Journal Online

Hepatobiliary College

Guidelines

Export File

Citation

Format

Content