2012-2015年北京市朝阳区乙型肝炎母婴传播阻断效果及影响因素  

Interruption of mother-to-infant transmission of hepatitis B virus, and factors influencing transmission interruption in Chaoyang district of Beijing, 2012-2015

作　　者：刘瑶瑶[1] 李倩[1] 葛申[1] 吴琼 张政[1] 马建新[1] Liu Yaoyao;Li Qian;Ge Shen;Wu Qiong;Zhang Zheng;Ma Jianxin(Chaoyang District Center for Disease Control and Prevention,Beijing 100021,China;College of Public Health,Zhejiang University,Hangzhou 31005&Zhejiang,China)

机构地区：[1]北京市朝阳区疾病预防控制中心,北京100021 [2]浙江大学公共卫生学院,浙江杭州310058

出　　处：《中国疫苗和免疫》2019年第4期388-392,共5页Chinese Journal of Vaccines and Immunization

基　　金：十三五国家科技重大专项艾滋病和病毒性肝炎等重大疾病防治(2018ZX10715005-003-004)

摘　　要：目的 评价乙型肝炎(乙肝)母婴传播阻断效果及其影响因素。方法 选择2012-2015年北京市朝阳区乙肝表面抗原(HBsAg)阳性母亲所生婴儿,实施乙肝疫苗(HepB)和乙肝免疫球蛋白(HBIG)联合免疫措施,在7-15月龄时检测乙肝血清标志物,分析乙肝母婴传播阻断效果及影响因素。结果 本研究共纳入HBsAg阳性母亲所生婴儿2 443名,HepB全程接种率、首剂HepB及时接种率、HBIG接种率、HBIG及时接种率分别为99.67%、97.46%、91.85%、88.21%;婴儿在7-15月龄时HBsAg阳性率为0.74%,母婴传播阻断成功的婴儿抗HBsAg抗体(HBsAb)阳性率为97.65%。乙肝e抗原(HBeAg)阳性母亲所生婴儿的HBsAg阳性率显著高于HBeAg阴性母亲所生婴儿(OR=4.88,95%C I:1.63-14.62)。结论 HepB和HBIG联合免疫措施对HBsAg阳性母亲所生婴儿具有显著的乙肝母婴传播阻断效果。母亲HBeAg阳性是乙肝母婴传播阻断失败的主要因素。Objective To evaluate interruption of mother-to-infant transmission of hepatitis B virus(HBV)and determine factors influencing interruption of transmission.Methods We selected infants born to HBV surface antigen(HBsAg)positive mothers during 2012-2015 in Chaoyang district of Beijing.Recommended practices is to administer hepatitis B vaccine(HepB)and hepatitis B immunoglobulin(HBIG)on the day of birth.We tested for serum HBV markers at 7-15 months of age to determine whether transmission was interrupted and to identify factors influencing interruption.Results The study included 2 443 infants born to HBsAg-positive mothers.Among these infants,coverage rates of 3 doses of HepB,timely first-dose of HepB,HBIG administration,and timely HBIG administration were 99.67%,97.46%,91.85%,and 88.21%,respectively.The positivity rate of HBsAg was 0.74%among infants at 7-15 months of age;the positivity rate of antibody against HBsAg(HBsAb)was 97.65%among HBsAg-negative infants.Infants born to HBV e antigen(HBeAg)positive mothers had a higher HBsAg positivity rate than those born to HBeAg-negative mothers(OR=4.88, 95%CI: 1.63-14.62).Conclusions The combined use of HepB and HBIG in infants born to HBsAg-positive mothers significantly prevented mother-to-infant transmission of HBV.Maternal HBeAg seropositivity was the major factor associated with prevention failure.

关 键 词：乙型肝炎疫苗 乙型肝炎免疫球蛋白 母婴传播阻断 

分 类 号：R512.62[医药卫生—内科学]