高病毒载量乙型肝炎病毒携带孕妇是否需要口服核苷(酸)类似物阻断母婴传播?

Considerations of using oral nucleos(t)ide analogues to interrupt mother-to-child transmission in HBV carrier pregnant woman with high viral load

乙型肝炎病毒(HBV)母婴传播是慢性HBV感染的主要传播途径,妊娠末期孕妇高病毒载量是导致新生儿联合免疫阻断失败的主要原因。而孕中晚期口服核苷(酸)类似物降低病毒载量,可以显著降低甚至完全阻断HBV母婴传播。现重点讨论高病毒载量HBV携带孕妇孕期口服核苷(酸)类似物抗病毒的必要性和可行性,开始用药时间及病毒载量阈值等问题。

The main transmission route of chronic hepatitis B virus infection is mother-to-child transmission of hepatitis B virus and the main cause of combined immune prophylaxis failure in neonates at the end of pregnancy is high viral load. Moreover, oral administration of nucleos(t)ide analogues (NAs) during the second and third trimesters of pregnancy can significantly reduce or even completely block mother-to-child transmission of HBV. This article focuses on the necessity and feasibility of oral NAs antiviral therapy for HBV carrier pregnant woman with high viral load, and the issues commences at the time of medication and viral load thresholds.