Vertical transmission of hepatitis B virus:propositions and future directions  

作　　者：Jin-Feng Liu Tian-Yan Chen Ying-Ren Zhao 

机构地区：[1]Department of Infectious Diseases,The First Affiliated Hospital of Xi’an Jiaotong University,Xi’an,Shaanxi 710061,China [2]Shaanxi Clinical Research Center of Infectious Diseases,Xi’an,Shaanxi 710061,China.

出　　处：《Chinese Medical Journal》2021年第23期2825-2831,共7页中华医学杂志（英文版）

基　　金：the National Natural Science Foundation of China(No.81670537);the Key R&D Program of Shaanxi(No.2018ZDXM-SF-037);the National Science and Technology Projects on Major Infectious Diseases(No.2017ZX10202202-002-006)。

摘　　要：Chronic hepatitis B virus(HBV)infection due to vertical transmission remains a critical concern with regards to eliminating HBV infection.Implementation of hepatitis B vaccine,the foundation to prevent perinatal and horizontal transmission,has reduced the prevalence of HBV by>80%.In countries where the hepatitis B immune globulin(HBIG)is available,such as China and the United States,the administration of HBIG and hepatitis B vaccine to the infants of mothers who are positive for hepatitis B surface antigen has become a standard practice and is effective in preventing vertical transmission.Accumulating evidence on the efficacy and safety of antiviral prophylaxis during pregnancy indicates the probability of attaining the goal of the World Health Organization to eliminate hepatitis by 2030.In this review,we discuss the transmission routes,diagnostic criteria,and preventive strategies for vertical transmission.A preventive program that includes screening before pregnancy,antiviral prophylaxis during pregnancy,and postpartum immunoprophylaxis provides“perfect strategies”to eliminate vertical transmission.However,there is still a notable gap between“perfect strategies”and real-world application,including insufficient coverage of timely birth dose vaccine and the efficacy and necessity of HBIG,especially in mothers who are negative for hepatitis B envelope antigen.In particular,there is a clear need for a comprehensive long-term safety profile of antiviral prophylaxis.Therefore,feasible and cost-effective preventive strategies need to be determined across regions.Access also needs to be scaled up to meet the demands for prophylaxis and prevalence targets.

关 键 词：Hepatitis B virus Vertical transmission IMMUNOPROPHYLAXIS Antiviral prophylaxis 

分 类 号：R512.62[医药卫生—内科学]