慢性病毒性肝炎垂直传播机制与预防。

StephenW

J Clin Transl Hepatol. 2017 Jun 28;5(2):119-129. doi: 10.14218/JCTH.2016.00067. Epub  2017 Jun 7.
Mechanisms and Prevention of Vertical Transmission in Chronic Viral Hepatitis.Mavilia MG1, Wu GY1.
Author information
1Department of Medicine, Division of Gastroenterology-Hepatology, University of Connecticut Health Center, Farmington, CT, USA.

AbstractVertical transmission (VT) is the primary route of transmission of viral hepatitis in children. The rate of VT ranges from 1-28% with hepatitis B virus (HBV) and 3-15% with hepatitis C virus (HCV). VT for both viruses can occur during the intrauterine or peripartum period. VT of HBV primarily occurs by intrauterine transmission (IUT). Hepatitis B surface antigen is unable to cross the placenta and, therefore, relies on processes like transplacental leakage, placental infection, cellular transmission by peripheral blood mononuclear cells, and germline transmission. HCV can also infect the fetus by IUT. Both viruses also have the potential for transmission during delivery, when there is increase chance of maternal-fetal blood exposure. HBV and HCV share some common risk factors for VT, including maternal viral load, human immunodeficiency virus co-infection and neonatal sex. Prevention of VT differs greatly between HBV and HCV. There are several alternatives for prevention of HBV VT, including antiviral medications during the third trimester of pregnancy and HBV vaccine, as well as hepatitis B immunoglobulin administration to infants post-partum. In contrast, there are no preventative interventions available for HCV. Despite these differences, the key to prevention with both viruses is screening women prior to and during pregnancy.


KEYWORDS: Hepatitis B; Hepatitis C; Mechanisms; Prevention; Vertical transmission

PMID:28660149PMCID:PMC5472932DOI:10.14218/JCTH.2016.00067

StephenW

J Clin Transl Hepatol。 2017年6月28日; 5（2）：119-129。 doi：10.14218 / JCTH.2016.00067。 Epub 2017 Jun 7
慢性病毒性肝炎垂直传播机制与预防。
马维利亚MG1，吴GY1。
作者信息

1
    美国康涅狄格州康涅狄格大学健康中心胃肠病学 - 肝病学系医学系。

抽象

垂直传播（VT）是儿童病毒性肝炎传播的主要途径。乙型肝炎病毒（HBV）的VT率为1-28％，丙型肝炎病毒（HCV）为3-15％。两种病毒的VT可以在宫内或周围产生。 HBV的VT主要发生在子宫内传播（IUT）。乙型肝炎表面抗原不能穿过胎盘，因此依赖于诸如胎盘渗漏，胎盘感染，外周血单核细胞的细胞传播和种系传播等过程。 HCV也可以通过IUT感染胎儿。当母体血液暴露的机会增加时，这两种病毒在分娩期间也有传播潜力。 HBV和HCV共有一些VT的常见危险因素，包括母体病毒载量，人类免疫缺陷病毒共感染和新生儿性别。 HBV与HCV的预防VT差异很大。有预防HBV VT的几种替代方案，包括妊娠三中期的抗病毒药物和HBV疫苗，以及产后产后的乙型肝炎免疫球蛋白。相比之下，没有可用的HCV预防性干预措施。尽管存在这些差异，但两种病毒预防的关键是在孕前和怀孕期间对妇女进行筛查。
关键词：

乙型肝炎丙型肝炎;机制;预防;垂直传输

结论：
    28660149
PMCID：
    PMC5472932
DOI：
    10.14218 / JCTH.2016.00067