《乙型肝炎病毒母婴传播预防临床指南(2020)》更新要点解读

Interpretation of Clinical Guidelines on Prevention of Mother-to-Child Transmission of Hepatitis B Virus(2020)

乙型肝炎病毒(HBV)母婴传播是导致我国人群慢性乙型肝炎(CHB)发病的主要原因,预防HBV母婴传播是控制CHB的关键。在《乙型肝炎病毒母婴传播预防临床指南(2013)》[以下简称为《HBV预防指南(2013)》]基础上,根据最新循证医学证据和文献报道,对其进行进一步修订和更新,颁布《乙型肝炎病毒母婴传播预防临床指南(2020)》[以下简称为《HBV预防指南(2020)》],从而使我国HBV母婴传播预防管理策略得到进一步优化。《HBV预防指南(2020)》更新推荐建议主要包括以下9个方面。①HBV感染临床诊断标准更新要点;②HBV母婴传播更新要点;③CHB妇女妊娠时机选择更新要点;④CHB孕妇孕期管理更新要点;⑤HBV母婴传播的新生儿免疫预防更新要点;⑥产妇乙型肝炎表面抗原(HbsAg)呈阴性,而家庭其他成员HBsAg呈阳性的子代HBV传播预防;⑦鼓励CHB产妇对其新生儿进行母乳喂养新增要点;⑧对CHB孕妇分娩婴幼儿随访更新要点;⑨预防HBV母婴传播的其他推荐建议更新要点。笔者拟就《HBV预防指南(2020)》的上述9个方面新增、更新要点,并结合其相关临床研究最新进展,对该指南进行解读,旨在帮助产科及儿科医师更新这方面知识,为临床更好预防HBV母婴传播提供参考。

Mother-to-child transmission of hepatitis B virus(HBV)is the main cause of chronic hepatitis B(CHB)in China,and prevention of mother-to-child transmission of HBV plays a critical role in controlling CHB.On the basis of Clinical Guidelines on Prevention of Mother-to-Child Transmission of Hepatitis B Virus(2013)(hereinafter referred to as"2013 HBV Prevention Guidelines"),and according to the latest evidence-based medical evidences and literatures,Clinical Guidelines on Prevention of Mother-to-Child Transmission of Hepatitis B Virus(2020)(hereinafter referred to as"2020 HBV Prevention Guidelines")were promulgated,so as to continuously optimize prevention and management strategies of mother-to-child transmission of HBV in China.The recommendations for"2020 HBV Prevention Guidelines"mainly include the following nine aspects.①Update points of clinical diagnostic criteria of HBV infection;②Update points of HBV mother-to-child transmission;③Update points of timing of pregnancy in women with CHB;④Update points of management of pregnant women with CHB during pregnancy;⑤Update points of neonatal immune prevention of HBV mother-to-child transmission of pregnant women with CHB;⑥Prevention of HBV transmission in offspring whose pregnant mother is hepatitis B surface antigens(HBsAg)negative and other family members are HBsAg positive;⑦New points to encourage mothers with CHB to breastfeed their newborns;⑧Update points for follow-up of infants of pregnant women with CHB;⑨Update points of other recommendations for prevention of HBV mother-to-child transmission.The authors intend to update the main points of the above nine aspects in"2020 HBV Prevention Guidelines",and interpret the guidelines in the light of the latest related clinical research progresses,in order to help obstetricians and pediatricians update this knowledge and provide reference for better clinical prevention of HBV mother-to-child transmission.