妊娠期慢性乙型肝炎发作抗病毒治疗策略

Antiviral treatment strategy of hepatic flare in pregnant women with chronic hepatitis B

由于机体内分泌及免疫系统发生改变,乙型肝炎病毒(hepatitis B virus,HBV)携带者妊娠后可以HBV再激活和肝炎发作,成为慢性乙型肝炎(chronic hepatitis B,CHB)患者。若不及时进行抗病毒治疗,妊娠期可能出现肝功能进一步恶化、甚至肝衰竭;同时胎儿可能早产甚至胎死宫内。妊娠期CHB发作进行抗病毒治疗可以改善孕妇的肝功能,并完成妊娠过程,还能降低HBV母婴传播。文章对妊娠期CHB发作抗病毒治疗的时机、抗病毒药物的选择和分娩后治疗策略进行了阐述。

Due to endocrine and immune system changes, hepatitis B virus （HBV） carriers after pregnancy can become chronic hepatitis B （CHB） patients with HBV reactivation and hepatic flare. Without antiviral treatment in time, pregnant women with hepatic flare may have worsening the liver function and even liver failure; meanwhile, the fetus may be premature or even result in intrauterine fetal death. Antiviral treatment for hepatic flare can improve the liver function of pregnant women and complete pregnancy process, and also reduce mother to child transmission of HBV. Tbis paper will make a review of antiviral treatment strategy of hepatic flare in pregnant women with CHB concerning opportunity and drug choice in pregnancy and delivery.