母乳喂养不影响乙型肝炎病毒母婴传播阻断效果

Breastfeeding Doesn't Pose an Additional Risk of Immunoprophylaxis Failure on the Infants of hbv Carrier Mothers

目的 比较不同喂养方式对 HBs Ag阳性母亲的婴儿母婴传播阻断效果的影响。 方法 HBs Ag阳性母亲的婴儿常规接种乙型肝炎疫苗或接受乙型肝炎疫苗和乙型肝炎免疫球蛋白联合免疫并随访。6 2例婴儿单用乙型肝炎疫苗免疫 ,2 1例母乳喂养 ,41例人工喂养 ;16 8例婴儿联合免疫 ,33例母乳喂养 ,135例人工喂养。 结果 单用疫苗时 1、3、6、12月龄抗 - HBs阳性率母乳喂养组分别为 4.8%、42 .9%、5 7.9%、80 .9% ,人工喂养组分别为 12 .2 %、2 6 .3%、6 0 .5 %、73.2 % ;联合免疫时 1、4、7、12月龄抗 - HBs阳性率母乳喂养组分别为 72 .7%、75 .8%、77.4%、90 .9% ,人工喂养组为77.0 %、72 .9%、76 .2 %、90 .4%。单用疫苗时 ,母乳喂养组 1例、人工喂养组 3例免疫失败 ;联合免疫时 ,母乳喂养组无一例免疫失败 ,人工喂养组 4例免疫失败 ,母乳喂养和人工喂养比较 ,差异均无显著性。 结论 母乳喂养不影响抗 - HBs产生 ,不增加免疫失败。

Objective To compare the influence of different feeding mode on the immunoprophylaxis efficacy of the babies born to hepatitis B (HB) carrier mothers. Methods The babies born to HB carrier mothers received HB vaccine alone routinely or HB immunoglobulin (HBIG) plus HB vaccine immunoprophylaxis were followed up. Among infants with HB vaccine alone, 21 were breastfed and 40 bottle-fed, among those with HBIG and HB vaccine, 33 were breastfed and 135 bottle-fed. Results Among babies receiving HB vaccine alone, the positive rates of anti-HBs at 1,3,6,12 month of age are 4.8%, 42.9%, 57.9%, 80.9% in breastfed group, and 12.2%, 26.3%, 60.5%, 73.2% in bottle-fed group. Among those with HBIG and HB vaccine, the positive rates of anti-HBs at 1, 4, 7, 12 month of age are 72.7%,75.8%,77.4%,90.9% in breastfed group, and 77.0%, 72.9%,76.2%,90.4% in bottle-fed group. With HB vaccine alone, 1 infant in breastfed group and 3 in bottle-fed group, and with HBIG and HB vaccine, 0 in breastfed group and 4 in bottle-fed group were chronically infected at 1-year of age. There are no significant differences of the incidence of anti-HBs and immunoprophylaxis failure between breastfed and bottle-fed babies. Conclusion Breastfeeding doesn't pose a negative influence on the response of anti-HBs and the failure rates of the HB immunoprophylaxis in the infants born to HB carrier mothers