Different interventional criteria for chronic hepatitis B pregnant women with HBeAg(+) or HBeAg(-): Epidemiological data from Shaanxi, China.
Different interventional criteria for chronic hepatitis B pregnant women with HBeAg(+) or HBeAg(-): Epidemiological data from Shaanxi, China.
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陕西省慢性乙型肝炎孕妇HBeAg(+)或HBeAg(-)流行病学数据的不同干预标准
DOI：
10.1097/md.0000000000011406
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发表时间：
2018-07
期刊：
影响因子：
1.6
通讯作者：
Liu J
中科院分区：
文献类型：
--
作者：
Chen T;Wang J;Qiu H;Yu Q;Yan T;Qi C;Cao F;Tian Z;Guo D;Yao N;Yang Y;He Y;Zhao Y;Liu J
对中国陕西省妇女的B型肝炎病毒（HBV）血清阳性率及其对妊娠结局的影响进行了评估。母婴传播（MTCT）的危险因素进行了评估的基础上HBV相关的血清阳性率数据。在招募的13，451例病例中，对HBeAg阳性母亲及其婴儿的病毒标志物和生化参数进行了评估。采用预测式结构化问卷对调查对象进行HBV相关知识的调查。采用描述性统计和Logistic回归分析方法分析母婴传播的可能危险因素。孕妇HBsAg总检出率为7.07%（951/13,451），检出率高达9.40%。HBeAg阳性孕妇中HBeAg阳性者占30.49%（290/951），HBVDNA>106 IU/mL者占22.08%（210/951），MTCT高危孕妇中接受抗病毒治疗者仅占16.19%（34/210）。 总的母婴传播率为5.21%。HBeAg阴性且HBV DNA>2 × 103 IU/mL和HBsAg >104 IU/mL的母亲发生MTCT的危险比和95%可信区间（95%CI）为26.062（2.633-258.024），显著高于HBeAg阳性且HBV DNA>106 IU/mL的母亲。 此外，HBV感染的母亲对HBV传播、危险因素和母婴传播干预的认识和知识普遍缺乏。由于HBeAg阴性、HBV DNA水平较低的母亲中HBsAg阳性率和MTCT率较高，因此本研究强调了HBeAg阳性和HBeAg阴性母亲的不同干预标准。孕期广泛的健康教育、常规筛查和乙肝疫苗接种是降低围产期传播的重要措施。
The seroprevalence of hepatitis B virus (HBV) and its impact on pregnancy outcomes of women from Shaanxi Province (China) was assessed. Risk factors for mother-to-child transmission (MTCT) were evaluated based on HBV-related seroprevalence data. Viral markers and biochemical parameters were assessed in HBsAg-positive mothers and their infants out of 13,451 cases recruited. A pretested and structured questionnaire was used to test the general HBV knowledge. Descriptive statistics and logistic regression analysis were done to reveal possible risk factors for MTCT. The overall prevalence of HBsAg in pregnant women was 7.07% (951/13,451), and a rate as high as 9.40% was observed. Among the HBsAg-positive pregnant women, 30.49% (290/951) were HBeAg-positive, 22.08% (210/951) had HBV DNA levels >106 IU/mL and only 16.19% with a high risk of MTCT (34/210) had received antiviral treatment. The overall MTCT rate was 5.21%. Noteworthy, the risk ratio and 95% confidence interval (95% CI) of MTCT in HBeAg-negative mothers with HBV DNA levels >2 × 103 IU/mL and HBsAg >104 IU/mL was 26.062 (2.633–258.024), which was significantly higher than that of HBeAg-positive mothers with HBV DNA level >106 IU/mL. Moreover, the awareness and knowledge about HBV transmission, risk factors, and intervention for MTCT were generally lacking among HBsAg-positive mothers. As a higher HBsAg seroprevalence and a higher MTCT rate among HBeAg-negative mothers with lower HBV DNA level was observed, our study emphasizes different interventional criteria for HBeAg-positive and HBeAg-negative mothers. Extensive health education, routine screening, and immunization against HBV during pregnancy are highly warranted to minimize the possibility of perinatal transmission.