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以母婴阻断为目的的抗乙型肝炎病毒药物治疗的停药时间

Optimal cessation period of anti-HBV therapy to block mother-to-child transmission
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摘要 高病毒载量慢性乙型肝炎病毒(HBV)携带的育龄期女性是我国HBV母婴垂直传播的重要传染源。针对HBV高病毒载量孕妇所生新生儿采用免疫球蛋白联合乙型肝炎疫苗进行常规阻断,仍有部分HBV母婴传播阻断失败;在妊娠期应用抗HBV药物,主要是为了降低孕妇血清病毒载量,提高母婴传播阻断率。如果产妇年龄小于30岁、无明显肝纤维化或肝硬化且治疗过程中也无丙氨酸氨基转移酶水平增高> 2倍正常值上限者,产后即可停用抗病毒药物治疗,并于停药后4、12、24周检查丙氨酸氨基转移酶水平,监测肝炎发作情况。如出现肝炎发作,达到治疗标准,可予以抗病毒治疗。 Hepatitis B virus (HBV) carrier woman of childbearing age with high viral load is an important source of vertical transmission of hepatitis b virus from mother-to-child in China. Routine blockade with immunoglobulin combined with hepatitis B vaccine is used for neonates born to pregnant women with high viral load of hepatitis B virus, but in some cases, immunoprophylaxis fails. The main application of antiviral drugs in pregnancy is to reduce the serum viral load, thereby significantly improve the blocking rate of vertical transmission between mother and infant. Current evidence suggested that if the maternal age is less than 30 years old, with no obvious liver fibrosis or cirrhosis and there is no increase in ALT level >2ULN( upper limit of normal) during the treatment, the treatment with antiviral drugs can be stopped after delivery immediately. Additionally, ALT level should be examined at 4, 12 and 24 weeks after stopping the drug. Antiviral therapy for the occurrence of hepatitis attack should be given if criteria for HBV treatment are met.
作者 郭茂 罗文强 张大志 Guo Mao;Luo Wenqiang;Zhang Dazhi(Department of Infectious Diseases,the Second Affiliated Hospital of Chongqing Medical University,Chongqing 400010,China)
出处 《中华肝脏病杂志》 CAS CSCD 北大核心 2019年第2期92-96,共5页 Chinese Journal of Hepatology
关键词 肝炎病毒 乙型 妊娠 母婴传播 抗病毒治疗 产后停药 Hepatitis B virus Pregnant Mother-to-child transmission Antiviral treatment Postpartum withdrawal
作者简介 通信作者:张大志,Email:zhangdazhi_1014@163.com.
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