HBV-DNA水平与HBIG母婴阻断效果影响因素分析

Impact of HBV-DNA levels on the blocking of transmission of hepatitis B from mothers to babies by injection of hepatitis B immunoglobulin

目的探讨HBV-DNA水平对HBIG母婴阻断效果的影响,研究提高阻断成功率的有效方法。方法将乙肝携带产妇和婴儿应用HBIG的情况按照HBV-DNA水平分层,分析HBIG不同使用方法和使用时机对阻断成功率的影响。结果儿童出生后乙肝球蛋白注射2针次与1针次的阻断成功率没有差别;HBV-DNA阳性的孕妇产前多次注射乙肝球蛋白可以提高阻断成功率。分娩方式、婴儿喂养方式对阻断成功率没有影响。结论 HBV-DNA阳性孕妇产前注射乙肝球蛋白3针次的阻断效果好,HBV-DNA阴性孕妇产前可以不注射乙肝球蛋白,而只在儿童出生后注射乙肝球蛋白,阻断效果即可达到最佳。自然分娩和母乳喂养对婴儿是安全的,不增加乙肝感染率。儿童出生后乙肝球蛋白注射1针次就可达到效果。

Aim To investigate the impact of HBV-DNA levels on the blocking of transmsstion of hepatitis B from mothers to the babies by injection of hepatitis B immunoglobulin （HBIG）. Methods Hepatitis B carrying mothers and infants injected with HBIG were investigated. Results There no significant differences were observed in infants given one to two injections of hepatitis B immunoglobulin for blocking transmssion of hepatitis B. The rate for successful blocking of heptitis B transmission from mothers to the babies could be enhanced by several injection of HBIG in HBV-DNA positive mothers before delivery. While no significant impact of delivery and feeding ways on the blocking rate was observed. Conclusions Antinatal one,two or three injection of HBIG in HBV-DNA positive pregnant women can blocking the transmission of hepatitis B,and the effect of protection of infants from infection of hepatitis B can be achived by one injection of HBIG in infants after birth.