Hepatitis B virus infection and pregnancy.

StephenW

Please read the following abstract with care. Management of HBV in pregnancy is complex:
For mothers:
1. Should mothers undergo treatment during her pregnancy for her own health?
For babies:
1. Should mothers have treatment before pregnancy?
2. Should mothers have treatment during early pregnancy when fetal development may be most easily affected?
3. Should mothers be treated in late pregnancy to further reduce risks of vertical transmission?
4. Is the drug safe for the unborn babies? Is the drug safe for breastfeeding babies?
[My personal opinions only. Always consult your doctors.StephenW]

Clin Res Hepatol Gastroenterol.
2011 Jun 7. [Epub ahead of print]
Hepatitis B virus infection and pregnancy.
Pol S, Corouge M, Fontaine H.
Source
Inserm U-1016, unité d'hépatologie, université Paris Descartes, AP-HP, hôpital
Cochin, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France.
Abstract

Pregnancy only mildly affects that natural progression of
acute and chronic infection by the hepatitis B virus (HBV) but it does
bring to light three important questions. Mother to child (vertical)
transmission risk is best prevented by mandatory HBs antigen testing in all
pregnant women in their second trimester and by systemic serovaccination of
newborns of infected mothers. In mothers with high viral load, vertical
infection in utero could be prevented by lamivudine, telbivudine or
tenofovir treatment. Invasive obstetric or gynecological procedures (such
as amniocentesis, forceps, etc.) do not seem to increase the risk of
vertical infection. Breastfeeding is not contraindicated in maternal HBV
infection after serovaccination of the newborn. This holds true for mothers
on active treatment with tenofovir which is not absorbed into breast milk.
When it comes to managing active antiviral treatment, in absence of
virosuppression with lamivudine, tenofovir remains a logical step-up
treatment; in absence of virosuppression with adefovir, tenofovir also
remains a logical step-up choice as do tenofovir/emtricitabine combinations
or lamivudine in absence of preexisting resistance which may have been
induced during combination treatment of adefovir and lamivudine. In cases
of effective virosuppression with treatment by analogues, lamivudine should
be continued and entecavir should eventually be replaced by lamivudine,
telbivudine or tenofovir; adefovir should be replaced by tenofovir or
lamivudine in absence of resistance (which would require tenofovir therapy)
or adefovir which would restrict lamivudine therapy.
Copyright © 2011
Elsevier Masson SAS. All rights reserved.PMID: 21659015  [PubMed - as
supplied by publisher]



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StephenW

请仔细阅读以下的摘要。在怀孕期间对HBV的管理是复杂的：
母亲：
1。为自己的健康,是否应该在怀孕期间接受治疗？
婴儿：
1。母亲是否应该在怀孕前治疗？
2。母亲是否应该在怀孕早期治疗, 当可能是最容易受影响胎儿发育的时间？
3。母亲是否应在妊娠晚期治疗，以进一步降低母婴垂直传播的风险？
4。药物对胎儿是安全的吗？药物对母乳喂养的婴儿安全吗？
[我的个人意见。务必咨询您的医生。 StephenW]

临床RES肝胆病胃肠病学杂志。
2011年06月07日。 [检索提前打印]
B型肝炎病毒感染与妊娠。
Pol S, Corouge M, Fontaine H.
来源
Source

INSERM的U - 1016，团结D' hépatologie，巴黎笛卡尔大学，AP - HP，总医院

Cochin，27街，杜的Faubourg -圣 - 雅克，75014巴黎，法国。
摘要

怀孕仅轻度影响，急性和慢性感染乙型肝炎病毒（HBV）自然进展
，但它带来三个重要的问题。母婴（垂直）传染的风险是最好的预防强制性HBS抗原检测孕妇在孕中期和全身serovaccination新生儿感染的母亲。在与病毒载量高，垂直的母亲在子宫内的感染是可以预防的，拉米夫定，替比夫定或替诺福韦治疗。侵入的产科或妇科程序（如如羊膜穿刺术，产钳等）似乎并没有增加的风险垂直感染。母乳喂养是没有禁忌产妇乙肝病毒感染后的新生儿serovaccination。这为母亲成立
积极治疗与替诺福韦这是不被吸收进入乳汁。当涉及到管理积极的抗病毒治疗，在缺乏virosuppression拉米夫定，泰诺福韦仍然是一个合乎逻辑的步骤，治疗; virosuppression的情况下，阿德福韦，替诺福韦也仍然是一个合乎逻辑的步骤选择，如替诺福韦/恩曲他滨的组合在没有预先存在的阻力可能已经或拉米夫定
诱导期间联合阿德福韦和拉米夫定治疗。案件有效virosuppression及类似物治疗，拉米夫定继续下去，最终要取代拉米夫定和恩替卡韦，替比夫定或替诺福韦;阿德福韦应改为替诺福韦或拉米夫定在没有阻力的情况下（这可能需要替诺福韦治疗）
或阿德福韦这将限制拉米夫定治疗。
© 2011
爱思唯尔马尾松SAS。所有权利reserved.PMID：21659015 [期刊 -
由出版商提供]

上海人

看不懂.

StephenW

王震宇     -1     连virosuppression、serovaccination都翻译.



virosuppression - viral suppression; serovaccination - sero vaccination。
由法国科学家写的.