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乙型肝炎病毒母婴传播机制及阻断策略研究进展

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母婴传播(MTCT)是中国慢性乙型肝炎病毒(HBV)感染的主要途径,系统了解HBV MTCT的发生机制和相关阻断策略,对提高阻断成功率至关重要.乙肝免疫球蛋白(HBIG)和乙型肝炎疫苗(HepB)的联合免疫在HBV MTCT的阻断上已取得较好疗效,但阻断失败的情况时有发生.高病毒载量孕妇发生宫内感染是阻断失败的主要原因,其感染途径有胎盘途径、外周血单个核细胞(PBMCs)途径、经生殖细胞感染途径等.孕期抗病毒治疗能有效阻断宫内感染,但各指南在治疗开始时间及HBV DNA阈值上仍未达成统一.本文对HBV MTCT发生机制及阻断策略予以综述,为进一步提高HBV MTCT阻断成功率提供参考.
Research progress on mechanism of mother-to-child transmission of hepatitis B virus and blocking strategies
Mother-to-child transmission(MTCT)is the main route of chronic hepatitis B virus(HBV)infection in China,and a systematic understanding of the mechanism MTCT of HBV and bloc-king strategies are of crucial for increasing the success rate of blocking.The combined immunization of hepatitis B immunoglobulin(HBIG)and hepatitis B vaccine(HepB)has achieved good efficacy,but failure in blocking often occurs.Intrauterine infection in pregnant women with high viral load is the main reason for failure,and the infection pathways include placental pathway,peripheral blood mono-nuclear cells(PBMCs)pathway,and infected germ cells pathway.Antiviral therapy during pregnancy can effectively block intrauterine infections,but various guidelines have not yet reached a consensus on the start time and the HBV DNA threshold.This paper summarized the mechanism and blocking strate-gies of MTCT in order to provide a reference for further increasing the success rate of blocking.

hepatitis B virusmother-to-child transmissionintrauterine infectionhepatitis B vaccinecombined immunizationantiviral therapy

金鑫、彭睿、高玲玲、周文杰

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扬州大学临床医学院/扬州大学附属苏北人民医院,江苏扬州,225001

乙型肝炎病毒 母婴传播 宫内感染 乙型肝炎疫苗 联合免疫 抗病毒治疗

国家自然科学基金

82203716

2024

实用临床医药杂志
扬州大学,中国高校科技期刊研究会

实用临床医药杂志

CSTPCD
影响因子:1.543
ISSN:1672-2353
年,卷(期):2024.28(4)
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