标题：乙型肝炎病毒母婴传播的机制和阻断研究进展

      作者：王洪伟 1，钟少华 2，姚津剑 3，吴彪 2    1.海南医学院第二附属医院产科，海南 海口 570311；2.海南省人民医院(海南医学院附属海南医院)感染病医学中心，海南 海口 570311；3.海南省人民医院(海南医学院附属海南医院)急诊医学中心，海南 海口 570311

      卷次： 2021年32卷17期

      【摘要】 乙型肝炎病毒(hepatitis B virus，HBV)感染是全球重大公共卫生健康问题之一，是慢性肝炎的最常见原因，发病率和病死率较高。我国属于HBV感染率高的国家，妊娠期母婴传播(mother to child transmission，MTCT)仍然是HBV的主要传播方式，乙肝疫苗联合乙肝免疫球蛋白(hepatitis B immunoglobulin，HBIG)主动-被动免疫是减少MTCT的有效途径，但仍有发生HBV MTCT风险，尤其是HBV DNA高病毒载量的孕妇。因此，妊娠期间应监测HBV DNA病毒载量以评估MTCT的风险和制定抗病毒治疗方案。HBV DNA≥2×105 IU/mL时应提倡在妊娠 28周开始富马酸替诺福韦二吡呋酯(tenofovir disoproxil fumarate，TDF)等抗病毒治疗，以降低MTCT的风险。
      【关键词】 乙型肝炎病毒；乙肝疫苗；母婴传播；抗病毒治疗；富马酸替诺福韦二吡呋酯
      【中图分类号】 R512.6+2 【文献标识码】 A 【文章编号】 1003—6350（2021）17—2258—05

Research progress on the mechanism and prevention of mother-to-child transmission of hepatitis B virus.
WANGHong-wei 1, ZHONG Shao-hua 2, YAO Jin-jian 3, WU Biao 2 1. Department of Obstetrics and Gynecology, the SecondAffiliated Hospital of Hainan Medical University, Haikou 570311, Hainan, CHINA; 2. Center for Infectious Diseases, HainanAffiliated Hospital of Hainan Medical University (Hainan General Hospital), Haikou 570311, Hainan, CHINA; 3. EmergencyMedical Center, Hainan Affiliated Hospital of Hainan Medical University (Hainan General Hospital), Haikou 570311,Hainan, CHINA【Abstract】 Hepatitis B virus (HBV) infection is one of the major public health problems in the world, which isthe most common cause of chronic hepatitis, with a high morbidity and mortality. China is a country with a high HBV in-fection rate. Mother to child transmission (MTCT) during pregnancy is still the main mode of HBV transmission. The ac-tive and passive immunization with hepatitis B vaccine and hepatitis B immunoglobulin (HBIG) is an effective way to re-duce MTCT, but there is still a risk of HBV MTCT, especially for pregnant women with high viral load of HBV DNA.Therefore, HBV DNA viral load should be monitored during pregnancy to assess the risk of MTCT and formulate antivi-ral treatment plan. When HBV DNA≥2×105 IU/mL, it is recommended to start antiviral therapy such as tenofovir diso-proxil fumarate (TDF) at 28 weeks of pregnancy to reduce the risk of MTCT.
      【Key words】 Hepatitis B virus; Hepatitis B vaccine; Mother-to-child transmission; Antiviral therapy; Tenofovirdisoproxil fumarate (TDF)·综述·doi:10.3969/j.issn.1003-6350.2021.17.022基金项目：海南省自然科学基金面上项目(编号：SQ2018MSXM0258)；海南省卫生健康行业科研项目(编号：18A200011、19A200110)；北京医卫健康基金会医学科学项目(编号：YWJKJJHKYJJ-B17318)