江西省两个地区乙型肝炎表面抗原阳性母亲所生新生儿乙型肝炎病毒母婴传播阻断效果和影响因素  

Effectiveness of interruption of mother-to-infant transmission of hepatitis B virus and its influencing factors among infants born to hepatitis B surface antigen positive mothers in two areas of Jiangxi province

作　　者：赵玉芹[1] 伍凤云[1] 廖征[2] 万晓萍 谢玉庆 谭楚生[1] Zhao Yuqin;Wu Fengyun;Liao Zheng;Wan Xiaoping;Xie Yuqing;Tan Chusheng(Jiangxi Provincial Center for Disease Control and Prevention,Nanchang 330029,Jiangxi,China;Nanchang Municipal Center for Disease Control and Prevention,Nanchang 330038,Jiangxi,China;Nanchang County Center for Disease Control and Prevention,Nanchang 330200,Jiangxi,China;Xinjian District Center for Disease Control and Prevention,Nanchang 330100,Jiangxi,China)

机构地区：[1]江西省疾病预防控制中心,江西南昌330029 [2]南昌市疾病预防控制中心,江西南昌330038 [3]南昌县疾病预防控制中心,江西南昌330200 [4]新建区疾病预防控制中心,江西南昌330100

出　　处：《中国疫苗和免疫》2021年第1期83-86,101,共5页Chinese Journal of Vaccines and Immunization

基　　金：江西省卫生计生委科技计划(20196006);中国肝炎防治基金会中国乙肝防控科研基金(YGFK20170041)。

摘　　要：目的探讨乙型肝炎(乙肝)表面抗原(HBsAg)阳性母亲所生新生儿乙肝疫苗(HepB)和乙肝免疫球蛋白(HBIG)联合免疫后的乙肝母婴传播阻断效果和影响因素。方法2016年6月-2019年1月在江西省两个区县选择HBsAg阳性母亲所生新生儿,实施首剂HepB(HepB1)和HBIG联合免疫以及HepB全程免疫,全程免疫后1-2个月检测血清HBsAg和乙肝表面抗体(HBsAb),分析HBsAg阳性率和影响因素。结果本研究共纳入HBsAg阳性母亲所生新生儿2281名,HepB1、HepB1联合HBIG、HepB全程及时接种率分别为99.43%、94.83%、30.47%;全程免疫后HBsAg阳性率为0.61%,HBsAb阳性率为98.47%;乙肝e抗原(HBeAg)同时阳性、阴性母亲的婴儿HBsAg阳性率分别为2.08%、0.12%(Fisher确切概率法,P=0.000)。结论HepB和HBIG联合免疫可有效阻断乙肝母婴传播;需探讨HBsAg和HBeAg同时阳性孕妇所生新生儿的乙肝母婴传播阻断措施。Objective To determine effectiveness of interruption of mother-to-infant transmission of hepatitis B virus(HBV)following co-administration of hepatitis B vaccine(HepB)and hepatitis B immunoglobulin(HBIG)to infants born to hepatitis B surface antigen(HBsAg)positive mothers,and to explore factors influencing effectiveness.Methods We recruited a sample of infants born to HBsAg-positive mothers in two counties of Jiangxi province from June 2016 to January 2019.Each infant received birth doses of HepB(HepB1)and HBIG,followed by two subsequent doses of HepB.We tested sera for HBsAg and hepatitis B surface antibody(HBsAb)1-2 months after the third dose of HepB.We determined HBsAg positivity and factors influencing positivity.Results A total of 2281 subjects were included in the study.Coverage levels of timely HepB1,HepB1 combined with HBIG,and full-series HepB were 99.43%,94.83%,and 30.47%,respectively.Positivity rates of HBsAg and HBsAb were 0.61%and 98.47%after full-series HepB vaccination.HBsAg positivity was 2.08%among subjects whose mothers were also positive for hepatitis B e antigen(HBeAg)and 0.12%among subjects whose mothers were negative to HBeAg(Fisher’s exact test,P=0.000).Conclusions Co-administration of HepB and HBIG followed by two subsequent doses of HepB can effectively interrupt transmission HBV from mother to infant.We should explore additional techniques for interruption of mother-to-infant HBV transmission for mothers positive for both HBsAg and HBeAg.

关 键 词：乙型肝炎 乙型肝炎病毒 乙型肝炎疫苗 乙型肝炎免疫球蛋白 预防接种 乙型肝炎表面抗原 乙型肝炎e抗原 乙型肝炎表面抗体 母婴传播 阻断 

分 类 号：R186[医药卫生—流行病学]