Notice!It is recommended that hepatitis B mothers do maternal and baby blocking treatment from 24 weeks of pregnancy!

Recently, the Medical Department of the Seventh Hospital of Zhongshan has officially opened the vertical propagation of the hepatitis B virus maternal and baby.

Hepatitis B Virus (HBV) is the pathogen that causes hepatitis B (referred to as hepatitis B).

Hepatitis B virus

HBV infection is a global public health problem. With the production and investment of genetic engineering vaccines and the popularization of hepatitis B vaccine, the HBV infection rate has declined.

The World Health Organization proposed that hepatitis B was "eliminated" in 2030 to reduce the new hair rate of hepatitis B to less than 90%.

According to the latest survey of hepatitis B serum epidemic in my country, the current hepatitis B surface antigen (S antigen, HBSAG) carrying rate of hepatitis B currently in the general population of China belongs to a moderate popular country.

In March 2018, the world’s authoritative medical magazine "Liuye Knife" released a report of "Global Bir and Prevention".

After reading the following data, you will find your heart.

Thanks to my country’s forced injection of hepatitis B vaccine to birth infants, the infection rate of hepatitis B children in my country is maintained in a stable range.Nevertheless, the absolute value of children in my country is still very large.

The rate of hepatitis B infection in children under 5 years old is about 0.2%-0.5%of the world’s children’s infection rate

The current quo of female hepatitis B in the childbearing age in my country

Hepatitis B virus maternal and baby vertical infection is the most important way for the spread of hepatitis B virus (HBV) in my country.

For patients and carriers of HBEAG, HBEAG and HBEAG (HBEAG), HBEAG (HBEAG negatives), although the baby is immunized according to the national plan (injected hepatitis B immunoglobulin, hepatitis B vaccine), there is still 5%-The 10%chance of infecting children.After his children were unfortunately infected with hepatitis B virus, 25%of infants and children may develop liver diseases such as cirrhosis and liver cancer in the future.

For children and adults over 3 years old, 90%of hepatitis B virus infections can remove hepatitis B virus through autoimmune effects and avoid chronic hepatitis B; in children aged 1-3The severe case is a baby under the age of 1, especially the siege period of the newborn (the baby is infected with hepatitis B virus during the fetus, during the birth of the fetus, and during the birth of birth).For companion.

Therefore, the age of infection with hepatitis B virus is the most important factor in chronicization of hepatitis B.

Therefore, prevention and intervention should be performed as soon as possible to standardize the management of female childbearing age before pregnancy, pregnancy, and postpartum infection, in order to better achieve the goal of "zero" transmission of "zero" transmission of HBV.

How to perform hepatitis B blocked therapy

In 2018, "Clinical Management Consensus on the Clinical Management of Hepatitis B Viruses infected with hepatitis B virus" (later referred to as consensus) mentioned that hepatitis B virus load (that is, HBV DNA level) in the bloodHepatitis B virus (virus load can be obtained through professional testing, and the currently adopted by Dian is basically adopted). At this time, it is recommended that the mother for maternal and baby hepatitis B blocking treatment is recommended.

"Consensus" also suggested that the treatment of hepatitis B maternal and infant blocking from 24-28 weeks of her mother’s pregnancy, and blocked HBV maternal and baby transmission through oral safety during pregnancy safety.Femolic acid tadolvir two pyrarododraxe (TDF) and tamabidin (LDT) are the drugs recommended by our guidelines.

Generally speaking, for the hepatitis B virus that has been normal with liver function, the drug can be discontinued after delivery.

For patients with hepatitis B and Primary Sanyang, when the hepatitis B is performed, the baby must also inject the infant’s hepatitis B immunoglobulin (HBIG) and hepatitis B vaccine after the baby is born.At the age of 7 to 1, he returned to the hospital to further check the hepatitis B surface antigen (S antigen), hepatitis B surface antibody (S antibody), etc.

Professor Chen Youpeng, deputy director of the infection of the Seventh Hospital of Zhongshan, pointed out: "The vertical spread of hepatitis B virus in China is very common. It is heartbroken that patients with hepatitis B often taboo disease and doctors.Doctors cannot accurately judge the infection and types of hepatitis B during treatment, and delay the best time to prevent and treat. "

He also reminded that if he hepatitis B virus carriers or chronic hepatitis B patients who are married to the age of marriage and childbirth, do not have to worry too much about the risk of hepatitis B virus in the next generation. Under the correct guidance and treatment of specialists, most women can look like other women like other women.Similarly, getting married normally and fertility.

【Reading News+】

1. When women are preparing to get pregnant, pay attention to the following points:

1. Women of childcare and preparation for pregnancy should screen HBSAG. Those who are positive for hepatitis B virus need to detect HBV DNA quantitative.

2. Female infected with HBV before or during pregnancy should be checked by liver function, imaging or liver pathology, and evaluate the risk of pregnancy based on the severity of the disease.

3. Patients with chronic hepatitis B or patients with hepatitis B patients with elevated serum ALT should immediately start antiviral treatment. After the condition is stable, under the guidance of a specialist.

2. Does hepatitis B antiviral drugs affect pregnancy?

First of all, interferon has caused fetal teratogenic, so whether it is male or female, the pharmaceutical manual stipulates that it cannot be used during pregnancy or conception.In addition, the effects of nucleoside analogs on pregnancy are divided into two categories: first, pregnancy B, pregnancy is available; there is also a category of pregnancy C. It is not recommended to use during pregnancy.

What do you mean by pregnancy B and C -Class?

According to the category of pregnancy safety in the US FDA drug, the grading of medication in pregnancy is four levels A, B, C, and D.Grade A is completely confirmed to be safe for the human body. Such drugs are the best; Class B indicates that there is no teratogenic condition through animal experiments, but the human body lacks large -scale evidence;In the case of abnormalities, there is no more evidence in the human body; the D -level is a problem, and it is not safe to be animals and people.Perial antiviral drugs at pregnancy B are now available in China.

Edit Li Yuting

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