核苷(酸)类药物阻断乙型肝炎病毒母婴传播的研究进展

Blocking mother-to-child hepatitis B transmission with nucleos(t)ide analogues:review of recent progress

我国是乙型肝炎(乙肝)病毒(hepatitis B virus,HBV)感染的中流行区[1]。由于新生儿感染HBV后,95%会成为慢性HBV携带者,因此母婴传播是导致慢性HBV感染率高的重要原因[2]。母婴传播的途径[3-4]大致可分为三种:大部分是由于产时感染,少部分来源于产后感染,而宫内感染的发生率很低。

Mother-to-child transmission of hepatitis B virus （HBV） leads to high prevalence of chronic HBV infection in China. Approximately 95% of children who infected HBV during perinatal period will develop into chronic HBV infection. Typically, mother-to-child transmission can be divided into three types： intrauterine, intrapartum and postpartum infection. The majority of perinatal HBV infection is intrapartum infection while the rates of postpartum and intrauterine infection are relatively low. Blocking mother-to child HBV transmis sion can significantly reduce HBV related morbidity and mortality. During the past several decades, a lot of studies have been dedicated to decreasing the incidence of mother to child HBV transmission. Administration of hepatitis B immune globulin （HBIG） at the time of birth plus three doses of the recombinant hepatitis B vac- cine during the first 6 months after hirth proved to he effective. Recently, nucleos（t）ide analogues have been used to prevent mother-to-child HBV transmission. Lamivudine, telbivudine and tenofovir seem to be effective to treat the infection.