2019年中国预防乙肝病毒母婴传播临床实践指南

StephenW

2019 Chinese Clinical Practice Guidelines for the Prevention of Mother-to-child Transmission of Hepatitis B Virus
Jinfeng Liu  1   2 , Tianyan Chen  1   2 , Yaolong Chen  3   4 , Hong Ren  5 , Guiqiang Wang  6 , Wenhong Zhang  7 , Yingren Zhao  1   2 , Society of Infectious Diseases and Chinese Medical Association
Affiliations
Affiliations

    1
    The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
    2
    Shaanxi Clinical Research Center of Infectious Diseases, Xi'an, Shaanxi, China.
    3
    Evidence-Based Medicine Center, Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China.
    4
    WHO Collaborating Centre for Guideline Implementation and Knowledge Translation, Lanzhou, Gansu, China.
    5
    Department of Infectious Diseases, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
    6
    Hepatology Center, Department of Infectious Diseases, Peking University First Hospital, Beijing, China.
    7
    Department of Infectious Diseases, Huashan Hospital Affiliated to Fudan University, Shanghai, China.

    PMID: 33447523 PMCID: PMC7782118 DOI: 10.14218/JCTH.2020.00070

Abstract

To develop the evidence-based guidelines for managing mother-to-child transmission of hepatitis B virus in China, a multidisciplinary guideline development group was established. Clinical questions were identified from two rounds of surveys on the concerns of first-line clinicians. We conducted a comprehensive search and review of the literature. A grading of recommendations' assessment, development, and evaluation system was adopted to rate the quality of evidence and the strength of recommendations. Recommendations were formulated based on the evidence, overall balance of benefits and harms (at individual and population levels), patient/health worker values and preferences, resources available, cost-effectiveness, and feasibility. Eventually, recommendations related to 13 main clinical concerns were developed, covering diagnostic criteria, treatment indications, antiviral therapy choice, timing to initiate and discontinue treatment, immunoprophylaxis strategy at birth, and how to deal with special situations, such as unintended pregnancy, assisted reproduction, and breastfeeding. The guidelines are intended to serve as guidance for clinicians and patients, to optimize the management of majority of pregnant women who are positive for hepatitis B surface antigen. Guideline registration: International Practice Guide Registration Platform (IPGRP-2018CN040).

Keywords: Clinical practice guidelines; GRADE; Hepatitis B virus; Mother-to-child transmission; Prevention.

© 2020 Authors.

StephenW

2019年中国预防乙肝病毒母婴传播临床实践指南
刘金凤1 2，陈天艳1 2，陈瑶龙3 4，洪仁5，王桂强6，张文宏7，赵英仁1 2，传染病学会和中华医学会
隶属关系
隶属关系

    1个
    西安交通大学附属第一医院，陕西西安
    2
    陕西省传染病临床研究中心，陕西西安。
    3
    兰州大学基础医学循证医学中心，甘肃兰州。
    4
    世卫组织准则实施和知识翻译合作中心，甘肃兰州。
    5
    重庆医科大学附属第二医院感染科，重庆。
    6
    北京大学第一医院传染病科肝病中心，北京
    7
    复旦大学附属华山医院传染病科，上海。

    PMID：33447523 PMCID：PMC7782118 DOI：10.14218 / JCTH.2020.00070

抽象

为了制定在中国管理乙肝病毒母婴传播的循证指南，成立了一个多学科指南制定小组。从两轮关于一线临床医生关注的调查中确定了临床问题。我们对文献进行了全面的搜索和审查。对建议的评估，制定和评估系统进行了分级，以评估证据的质量和建议的强度。根据证据，利弊整体平衡（在个人和人群水平），患者/卫生工作者的价值观和偏好，可用资源，成本效益和可行性，制定建议。最终，提出了与13个主要临床问题相关的建议，包括诊断标准，治疗适应症，抗病毒治疗选择，开始和终止治疗的时机，出生时的免疫预防策略以及如何应对特殊情况，例如意外怀孕，辅助生殖和母乳喂养。该指南旨在为临床医生和患者提供指导，以优化对大多数乙型肝炎表面抗原阳性孕妇的管理。指南注册：国际实践指南注册平台（IPGRP-2018CN040）。

关键字：临床实践指南；年级;乙型肝炎病毒;母婴传播；预防。

©2020作者。

StephenW

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