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1.
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。  相似文献   

2.
目的探讨乙型肝炎(乙肝)表面抗原(HBsAg)和e抗原(HBeAg)阳性产妇所生新生儿在出生后乙肝疫苗(HepB)和乙肝免疫球蛋白(HBIG)联合免疫以及完成HepB全程免疫后乙肝病毒(HBV)突破性感染的影响因素。方法2016年6月-2017年5月在南昌市2个县(区)选择HBsAg和HBeAg阳性产妇所生新生儿,在联合免疫和HepB全程免疫完成后1-2个月检测血清HBsAg和乙肝表面抗体(HBsAb),分析儿童母婴传播阻断失败率(HBsAg阳性率)。结果本研究共纳入278名婴儿,母婴传播阻断失败率为2.52%(7/278),HBsAb阳性率为96.8%(269/278)。产妇HBsAg阳性时间在2年以上是阻断失败的危险因素,而分娩方式、喂养方式、母亲和婴儿HBIG的使用情况和婴儿性别等与HBV阻断失败率无相关性。结论HepB和HBIG联合免疫对HBsAg和HBeAg阳性产妇所生新生儿具有较好的乙肝母婴传播阻断效果,建议加强育龄妇女HBsAg和HBeAg筛查。  相似文献   

3.
目的分析母亲乙肝病毒(hepatitis B virus,HBV)携带状况与新生儿乙肝疫苗(hepatitis B vaccine,HepB)免疫效果之间的关系,为阻断HBV母婴传播提供依据。方法在邯郸市随机抽取8022名满7月龄--2周岁儿童及其母亲,调查儿童的HepB接种情况,采取试纸和酶联免疫吸附试验方法检测母子HBV标志物携带状况,并检测HBsAg阳性母亲的HBV基因型。结果母亲HBsAg阳性率为2.43%,儿童阳性率为0.45%,HepB保护率为81.48%。143名HBsAg阳性母亲中有127名C型,占97.69%。26对母子名HBsAg均阳性的母亲中,大三阳9名,小三阳5名,HBsAg和HBcAb阳性10名,三者差异有统计学意义(χ^2=6.03,P〈0.05)。结论母亲HBV基因型中以C型为主。阻断HBsAg阳性的母婴传播应采取联合接种HepB和乙肝高效免疫球蛋白等综合措施,同时,HBsAg和HBcAb双阳性母亲在母婴传播中的意义不可忽视。  相似文献   

4.
目的探讨接种重组乙型肝炎(乙肝)疫苗(HepB)(酵母)阻断乙肝病毒(HBV)母婴传播的影响因素。方法在北京市、甘肃省和浙江省宁波市选择1997~2005年孕期或住院分娩时检测乙肝病毒表面抗原(HBsAg)阳性的母亲及其儿童,进行问卷调查和采集血清标本,用固相放射免疫法检测HBV血清学标志物,分析儿童HBsAg的影响因素,在单因素的基础上进行多因素非条件Logistic回归分析,探索接种重组HepB(酵母)阻断HBV母婴传播的影响因素。结果共调查719名儿童,HBsAg阳性率为10.01%。HepB接种剂量、母亲HBV感染状况和母乳喂养是接种重组HepB(酵母)阻断HBV母婴传播的主要影响因素,而分娩方式、母亲孕期是否联合免疫乙肝免疫球蛋白(HBIG)等,对接种重组HepB(酵母)阻断HBV母婴传播不产生影响。结论筛查母亲HBV感染状态、对HBsAg阳性母亲的新生儿联合免疫10μg×3重组HepB(酵母)对提高阻断HBV母婴传播的效果具有重要意义。剖宫产、母亲孕期接种HBIG不能提高阻断HBV母婴传播的效果。母乳喂养对阻断HBV母婴传播效果的影响还需进一步研究。  相似文献   

5.
目的观察重组(酵母)乙型肝炎(乙肝)疫苗阻断乙肝病毒(HBV)母婴传播的长期效果,探讨阻断HBV母婴传播的最佳免疫策略.方法对母亲血清乙肝病毒表面抗原(HBsAg)和乙肝病毒膜抗原(HBeAg)同时阳性、新生儿期全程接种乙肝疫苗后HBsAg阴性的273名儿童进行9年血清学追踪观察.结果共观察到12人HBsAg阳转,1~9岁HBsAg阳性率0.72%~6.98%,低或无应答儿童9岁内17.78%发生HBsAg阳转;免疫后9年保护性水平乙肝病毒表面抗体(抗-HBs)阳性率仍维持>60%;3~5岁加强免疫儿童抗体阳性率及抗体水平高于未加强免疫儿童.结论重组(酵母)乙肝疫苗对阻断HBV母婴传播具有良好的远期免疫效果.母亲HBsAg和HBeAg双阳性的幼儿在3~4岁时需加强免疫.低或无应答新生儿有较高的HBsAg阳转危险性.  相似文献   

6.
乙型肝炎(乙肝)表面抗原(Hepatitis B surface antigen, HBsAg)阳性母亲所生新生儿是乙肝病毒(Hepatitis B virus, HBV)感染的高危人群,乙肝疫苗(Hepatitis B vaccine, HepB)和乙肝免疫球蛋白(Hepatitis B immunoglobulin, HBIG)联合免疫后乙肝表面抗体(Hepatitis B surface antibody, HBsAb)水平随时间推移而下降,部分儿童无免疫应答或低应答,仍有HBV感染风险。本文基于国内外相关研究文献,对HBsAg阳性母亲所生新生儿HepB和HBIG联合免疫后的免疫原性、免疫持久性和保护效果进行了综述,为完善乙肝母婴传播阻断措施提供参考。  相似文献   

7.
目的评价不同剂量(10μg×3和5μg×3)重组乙型肝炎(乙肝)疫苗(HepB)(酵母)与乙肝免疫球蛋白(HBIG)联合免疫阻断乙肝病毒(HBV)母婴传播的效果。方法在北京市、甘肃省和浙江省宁波市选择1997~2005年孕期或住院分娩时检测乙肝病毒表面抗原(HBsAg)阳性的母亲及其儿童,采用问卷调查和血清学检测(固相放射免疫)方法,比较不同剂量(10μg×3和5μg×3)重组HepB(酵母)与HBIG联合免疫阻断HBV母婴传播的效果。结果接种10μg×3重组HepB(酵母)无论是否与HBIG联合免疫,儿童HBsAg阳性率差异无显著的统计学意义(χ2=0.474,P>0.05),儿童HBsAg阳性率为2.15%,HBV母婴传播阻断率为97.47%。接种5μg×3重组HepB(酵母)与HBIG联合免疫的儿童HBsAg阳性率显著低于未联合免疫儿童(2χ=4.391,P<0.05),联合免疫儿童HBsAg阳性率为8.55%,HBV母婴传播阻断率为89.94%;未联合免疫儿童HBsAg阳性率为16.55%,HBV母婴传播阻断率为80.52%。其中母亲HBsAg和乙肝病毒e抗原(HBeAg)同时阳性(双阳性,下同)的联合免疫儿童,HBsAg阳性率为8.82%,非常明显的低于未联合免疫儿童(34.00%)(2χ=7.071,P<0.01);母亲HB-sAg阳性、HBeAg阴性的联合免疫儿童,HBsAg阳性率8.43%,未联合免疫儿童,HBsAg阳性率13.01%,差异无显著的统计学意义(χ2=1.243,P>0.05)。结论对母亲HBsAg阳性的儿童,重组HepB(酵母)与HBIG联合免疫阻断HBV母婴传播的效果,较未联合HBIG免疫者更佳,但接种10μg×3重组HepB(酵母)未联合HBIG免疫也能取得相同的保护效果,而接种5μg×3重组HepB(酵母)的儿童,尤其是母亲双阳性儿童,与HBIG联合免疫还是有必要的。  相似文献   

8.
目的 观察乙肝免疫球蛋白和乙肝疫苗联合免疫方案在乙型肝炎病毒(HBV)母婴传播中的阻断效果及影响因素。方法 对397例乙肝表面抗原(HBsAg)阳性产妇及所生婴幼儿进行分析,观察乙肝疫苗和乙肝免疫球蛋白接种的免疫效果,采用多因素Logistic回归方法分析母婴阻断效果的影响因素。结果 397例HBsAg阳性产妇所生新生儿中HBsAg阳性婴幼儿38例,母婴阻断失败率为9.57%。分娩方式、母亲乙肝DNA病毒含量、母亲HBeAg阳性情况不同的婴幼儿免疫效果差异有统计学意义(均P<0.01)。母亲HBeAg阳性(OR=20.323)、阴道自然分娩(OR=4.425)、血清HBV高载量(OR=4.027)增加母婴阻断失败风险。结论 高危新生儿接种乙肝疫苗和乙肝免疫球蛋白后具有显著的母婴阻断效果。母亲HBeAg表达模式、分娩方式及HBV载量为影响阻断的重要因素。  相似文献   

9.
目的观察乙型肝炎(乙肝)疫苗与乙肝免疫球蛋白(HBIG)联合免疫阻断乙肝病毒(HBV)母婴传播的效果,探讨母婴阻断失败的影响因素。方法以山东省寿光市2005-2015年HBV感染者母亲及所生的儿童为研究对象,采取问卷调查和血清采集,应用ELISA检测HBV血清学5项指标,母亲及儿童的感染状况以随访检测结果为准。检测结果判定以儿童乙肝表面抗原(HBsAg)阳性为阻断失败。结果共调查儿童1 372名,母婴阻断失败率2.92%。其中,乙肝疫苗与HBIG联合免疫阻断失败率2.23%,单用乙肝疫苗阻断失败率6.67%;10μg酵母乙肝疫苗与HBIG联合免疫阻断失败率1.77%,5μg酵母乙肝疫苗与HBIG联合免疫阻断失败率4.41%。母亲乙型肝炎e抗原(HBeAg)阳性、生育年龄、生育方式等是阻断失败的主要影响因素,而儿童性别、喂养方式、孕晚期母亲是否接种HBIG、儿童出生后接种HBIG的次数等与阻断失败率无相关性。结论 HBV母婴阻断效果,乙肝疫苗与HBIG联合免疫优于未联合免疫,10μg酵母乙肝疫苗优于5μg乙肝疫苗,建议进一步开展大剂量乙肝疫苗与HBIG联合免疫研究。  相似文献   

10.
目的观察10μg与5μg乙型肝炎(乙肝)疫苗(HepB)与乙肝免疫球蛋白(HBIG)联合免疫阻断乙肝病毒(HBV)母婴传播的效果。方法以山东省寿光市5个街道2005-2015年住院分娩的HBV表面抗原(HBsAg)阳性的母亲及所生儿童(2-12岁)为研究对象,进行问卷调查和采集血清,用ELISA方法检测HBV血清学标志物,分析5μg和10μg HepB与HBIG联合免疫后的HBV母婴传播阻断失败率及影响因素。结果共纳入HBsAg阳性母亲所生儿童696人,其中5μg组245人、10μg组451人。Hep B与HBIG联合免疫后,HBsAg阳性19人,HBV母婴传播阻断失败率为2.73%,其中5μg组、10μg组分别为4.49%、1.77%(χ~2=5.98,P=0.014)。HBVe抗原(HBeAg)阳性母亲所生儿童的阻断失败率以5μg组(20.00%)显著高于10μg组(5.22%)(χ~2=6.85,P=0.009)。结论 10μg HepB的HBV母婴传播阻断效果优于5μg HepB。  相似文献   

11.
目的了解2019年云南省<15岁儿童乙型肝炎(乙肝)血清流行率。方法采用分层随机抽样在云南省所有县(市、区)抽取387个乡镇1149个村(居委会、社区)的8月龄-14岁儿童,采用酶联免疫吸附试验检测血清乙肝表面抗原(HBsAg)、乙肝表面抗体(HBsAb)和乙肝核心抗体(HBcAb),分析三项标志物组合模式和阳性率。结果在21177名调查儿童中共检出8种HBsAg、HBsAb和HBcAb组合模式,其中三项指标均阴性、仅HBsAb阳性、HBsAb和HBcAb阳性、仅HBcAb阳性分别占31.26%、59.40%、6.46%、2.51%。儿童HBsAg、HBsAb、HBcAb总阳性率分别为0.37%、66.00%、9.17%;乙肝疫苗(HepB)全程接种、未全程接种、免疫史不详儿童HBsAg阳性率分别为0.35%、0.59%、0.82%(χ2=5.27,P=0.07);首剂及时、不及时接种儿童分别为0.34%、0.58%(χ2=4.48,P=0.03)。8月龄-4岁、5-9岁、10-14岁儿童HBsAg阳性率分别为0.32%、0.43%、0.61%(趋势χ2=5.05,P=0.03)。结论2019年云南省8月龄-14岁儿童HBsAg阳性率降至较低水平,但随年龄增长呈增加趋势;HepB接种对阻断儿童乙肝传播的效果显著。需进一步提高适龄儿童HepB全程和首剂及时接种率。  相似文献   

12.
陕西省人群乙型肝炎血清流行病学调查   总被引:3,自引:2,他引:1  
目的了解陕西省人群乙型肝炎(乙肝)病毒(HBV)感染现状,评价接种乙肝疫苗(HepB)15年后人群血清流行病学变动情况。方法采用多阶段随机抽样方法,抽取1~59岁人群2 224人进行问卷调查并采集血标本,用ELISA方法检测HBV血清学标志。结果调查人群HBsAg、抗-HBs、抗-HBc标化阳性率分别为3.50%、48.51%、24.45%,HBV标化感染率为37.58%。HepB接种率为50.09%,接种人群HBsAg阳性率(1.62%)及HBV感染率(8.80%)低于未接种人群(4.05%、50.00%)。15岁以下儿童HBsAg、抗-HBc阳性率和HBV感染率低于15岁以上人群,而抗-HBs阳性率、HepB接种率高于15岁以上人群。HBsAg阳性率、HBV感染率较1992年流行病学调查结果分别下降54.78%、31.86%,抗-HBs阳性率上升60.79%。HBV感染率农村(33.33%)高于城市(24.17%),HepB接种率城市(88.61%)高于农村(75.96%)。结论陕西省实施HepB接种15年后,HBsAg阳性率、HBV感染率均有不同程度下降,15岁以下儿童下降更为明显。  相似文献   

13.
《Vaccine》2017,35(33):4229-4235
ObjectiveTo evaluate prenatal maternal hepatitis B virus (HBV) screening and post-vaccination hepatitis B surface antigen (HBsAg) and antibody to hepatitis B surface antigen (anti-HBs) status and titers of babies born to HBsAg positive mothers, and to provide evidence for development of standard postvaccination serologic testing (PVST) strategies for babies born to HBsAg positive mothers in China.MethodsIn 2014, we conducted a baseline survey of HBV mother to child transmission (MTCT) interruption strategy implementation and PVST for babies born to HBsAg positive mothers after received 3 doses of hepatitis B vaccine (HepB) in 8 counties in 4 Provinces. Bivariate analysis and multivariable analyses modeled statistically significant predictor variables associated with infant HBsAg, anti-HBs positive, anti-HBs titer.ResultsAmong the 1563 infants born to HBsAg positive mothers, 1025 (65.6%) maternal-infant pairs were enrolled in PVST after receiving 3 doses of HepB. 38 infants tested HBsAg positive for an HBsAg positive rate of 3.7%. Maternal hepatitis B e antigen (HBeAg) status and age of infant were significantly associated with infant HBsAg positivity. A total of 932 infants were anti-HBs positive when tested at 7–24 months of age, yielding an anti-HBs positivity rate of 90.9%. Maternal HBeAg status was the factor associated with infant anti-HBs status. Amount of antigen of HepB and infant’s age were most associated with anti-HBs titers. PVST performed 1–2 months after the 3rd dose of HepB was associated with the highest anti-HBs level and the anti-HBs Geometric Mean Concentration (GMC) decreased as the PVST intervals prolonged.ConclusionsIn China, perinatal HBV transmission is approaching the theoretical minimum possible with the current strategy of HepB coupled with HBIG administration for HBV-exposed newborns. PVST of infants born to an HBsAg positive mother is an essential strategy to ensure full protection for vaccine non-responders and appropriate medical care for those infected.  相似文献   

14.
《Vaccine》2022,40(19):2741-2748
Sierra Leone is highly endemic for hepatitis B virus (HBV) infection and thus recommends three doses of hepatitis B vaccine (HepB3) from 6 weeks of age but does not recommend a birth dose (HepB-BD) to prevent mother-to-child transmission (MTCT). We evaluated impact of the existing HepB3 schedule and risk for MTCT of HBV. We conducted a community-based serosurvey among 4–30-month-olds, their mothers, and 5–9-year-olds in three districts in Sierra Leone. Participants had an HBV surface antigen (HBsAg) rapid test; all HBsAg-positive and one HBsAg-negative mother per cluster were tested for HBV markers. We collected children’s HepB3 vaccination history. Among 1889 children aged 4–30 months, HepB3 coverage was 85% and 20 (1·3% [95% CI 0·8–2·0]) were HBsAg-positive, of whom 70% had received HepB3. Among 2025 children aged 5–9 years, HepB3 coverage was 77% and 32 (1·6% [1·1–2·3]) were HBsAg-positive, of whom 56% had received HepB3. Of 1776 mothers, 169 (9·8% [8·1–11·7]) were HBsAg-positive. HBsAg prevalence was 5·9% among children of HBsAg-positive mothers compared to 0·7% among children of HBsAg-negative mothers (adjusted OR = 10·6 [2·8–40·8]). HBsAg positivity in children was associated with maternal HBsAg (p = 0·026), HBV e antigen (p < 0·001), and HBV DNA levels ≥ 200 000 IU/mL (p < 0·001). HBsAg prevalence was lower among children than mothers, for whom HepB was not available, suggesting routine infant HepB vaccination has lowered HBV burden. Since HBsAg positivity in children was strongly associated with maternal HBV infection and most of the HBsAg-positive children in the survey received HepB3, HepB-BD may prevent MTCT and chronic HBV infection.  相似文献   

15.
BackgroundBefore hepatitis B vaccine (HepB) introduction, level of endemicity of hepatitis B virus (HBV) in Ukraine was estimated as intermediate but the prevalence of HBV infection markers has not been measured in population-based serosurveys. Coverage with 3 doses of HepB, introduced in 2002, was 92%-98% during 2004–2007 but declined to 21%-48% during 2010–2016. To obtain data on HBV prevalence among children born after HepB introduction, we tested specimens from a serosurvey conducted in Ukraine in 2017, following circulating vaccine-derived poliovirus outbreak in 2015, among birth cohorts eligible for polio immunization response.MethodsThe serosurvey was conducted in Zakarpattya, Sumy, and Odessa provinces, and Kyiv City, targeting 2006–2015 birth cohorts. One-stage cluster sampling in the provinces and stratified simple random sampling in Kyiv were used for participant selection. All participants were tested for antibodies against HBV core antigen (anti-HBc). Anti-HBc-positive children were tested for HBV surface antigen (HBsAg). We also obtained information on HepB vaccination status for all children.ResultsOf 4,596 children tested, 81 (1.8%) were anti-HBc-positive and eight (0.2%) were HBsAg-positive. HBsAg prevalence was 0.7% (95% confidence interval, 0.3%-1.4%) in Zakarpattya, 0.1% (0.0%-0.4%) in Sumy, 0% (0.0%-03%) in Odessa, and 0.1% (0.0%-0.8%) in Kyiv. Across survey sites, the proportion of recipients of ≥ 3 HepB doses was 53%-80% in the 2006–2009 cohort and 28%-59% in the 2010–2015 cohort.ConclusionHBV prevalence among children in surveyed regions of Ukraine in 2017 was low, including in Zakarpattya—the only site above the 0.5% European Regional target for HBsAg seroprevalence. However, HepB vaccination was suboptimal, particularly among children born after 2009, resulting in large numbers of unvaccinated or incompletely vaccinated children at risk of future HBV infection. HepB coverage should be increased to further reduce HBV transmission among children in Ukraine and achieve regional and global hepatitis B control/elimination targets.  相似文献   

16.
目的 评价乙型肝炎疫苗(HepB)联合乙型肝炎免疫球蛋白(HBIG)对乙型肝炎表面抗原(HBsAg)阳性的慢性乙型肝炎病毒(HBV)感染孕妇子女的免疫效果.方法 326例乙型肝炎e抗原(HBeAg)阴性HBV感染孕妇及其分娩的375例子女纳入本研究,记录母亲孕期HBIG使用情况、分娩方式、子女出生后免疫预防措施和喂养方式,并进行HBV标志物比较.结果 375例子女均在出生12h内使用了HBIG,352例(93.9%)出生24 h内接种了第1针HepB,23例(6.1%)均因存在各种新生儿疾病而延迟,但分别在出生后7 ~42 d进行补接种.236例行脐带血检测HBV标志物,39例(16.5%)HBsAg阳性,197例(83.5%)HBsAg阴性,脐带血HBsAg阳性与阴性子女抗-HBs阳性率及抗-HBs中位浓度比较差异无统计学意义(P>0.05).孕期使用HBIG与未使用HBIG母亲的子女抗-HBs阳性率分别为63.5%(47/74),59.8%(180/301);剖宫产与自然分娩的子女抗-HBs阳性率分别为65.2%(103/158),57.1%(124/217),母乳喂养、混合喂养、人工喂养的子女抗-HBs阳性率分别为62.0%(119/192),58.9%(63/107),59.2%(45/76),差异均无统计学意义(P>0.05).结论 HBeAg阴性HBV感染孕妇的子女经正规的HBIG联合HepB免疫预防后,不同的分娩方式、喂养方式、孕晚期是否使用HBIG对子女HepB的免疫应答与HBV的母婴传播无影响.  相似文献   

17.
乙肝孕妇所生婴儿乙肝感染情况的对照研究   总被引:2,自引:0,他引:2  
目的:探讨孕妇不同的乙肝感染状态经被动免疫后所生婴儿乙肝感染情况。方法:将57例HBsAg阳性孕妇分为乙肝“大三阳”组及乙肝“小三阳”组,同时又分为被动免疫组和未被动免疫组。对被动免疫组从孕28周起1次/4周肌注乙肝免疫球蛋白,200 U/次,共3次,对其所生的婴儿于生后24 h、6个月及1岁时测定乙肝“两对半”。结果:经被动免疫孕妇所生婴儿抗HBs抗体产生率明显高于未被动免疫组(P<0.05)。乙肝“大三阳”孕妇孕期经被动免疫所生婴儿抗HBs抗体的产生率明显高于未经被动免疫的乙肝“大三阳”孕妇所生婴儿抗HBs抗体的产生率。乙肝“小三阳”孕妇经被动免疫和未被动免疫所生婴儿抗HBs抗体的产生率及乙肝感染率无明显差异。结论:被动免疫可以阻断乙肝宫内感染的发生,使婴儿在宫内得到被动免疫,乙肝“大三阳”孕妇是发生宫内感染的高危因素。  相似文献   

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