Management and treatment of pregnant women with hepatitis B]

StephenW

Ned Tijdschr Geneeskd. 2009;153:A905.

[Management and treatment of pregnant women with hepatitis B]
[Article in Dutch]

Boland GJ, Veldhuijzen IK, Janssen HL, van der Eijk AA, Wouters MG, Boot HJ.

Nationaal Hepatitis Centrum, Amersfoort, The Netherlands. [email protected]

Every year about 800 chronic hepatitis B infections are identified in the
Netherlands as result of the nationwide pregnancy screening. About one-third
of these are newly discovered infections. In recent years there has been a
marked increase in treatment options for chronic hepatitis B infection using
antiviral drugs. Pregnant women can now be treated as well. A pregnant woman
with a low viral load does not require immediate treatment, as due to the
passive immunisation and active vaccination of the newborn the chances of
infection due to perinatal transmission are negligible. Treatment of the
mother can therefore be postponed until after the birth. However, when the
pregnant woman has a high viral load (>10(9) copies/ml in serum), perinatal
transmission can still occur despite vaccination of the newborn. In these
women, antiviral treatment in the last trimester of the pregnancy should be
considered. At present, experience of treating HBV-infected pregnant women has
only been gained with lamivudine. It appears that the quantity of circulating
virus decreases due to the treatment. Treatment should always be supervised by
a gastroenterologist or an infectiologist. Detection, referral and treatment
of the mother and child are described in several guidelines that have recently
been updated and harmonized with each other. These include a practice
guideline from the Dutch College of General Practitioners, a guideline from
the Centre for Infectious Disease Control of the National Institute for Public
Health and the Environment, and a guideline from the Netherlands Society of
Gastroenterology.
PMID: 20051170 [PubMed - in process

11号宅男

最好能给一个原文的连接。另外，能不能将重点摘出来翻一点给不懂英文的战友阅读？

11号宅男

我先来一点：

However, when the pregnant woman has a high viral load (>10(9) copies/ml in serum), perinatal transmission can still occur despite vaccination of the newborn. In these women, antiviral treatment in the last trimester of the pregnancy should be considered. At present, experience of treating HBV-infected pregnant women has only been gained with lamivudine. It appears that the quantity of circulating virus decreases due to the treatment. Treatment should always be supervised by a gastroenterologist or an infectiologist.

然而，孕妇的病毒载量较高（血清中的病毒量大于10(9) copies/ml ）时，即使给新生儿注射疫苗，母婴传播仍有可能发生。这些孕妇应考虑在妊娠的最后一个阶段进行抗病毒治疗。目前，（我们）只试过用拉米夫定治疗HBV孕妇，试验结果表现为：经过治疗，病毒的传播（循环？）量减少。治疗的过程应始终在肠胃医师或传染病医师的指导下进行。

[ 本帖最后由 11号宅男 于 2010-1-13 22:10 编辑 ]

StephenW

The original article is in Dutch. It is published in Ned Tijdschr Geneeskd. 2009;153:A905.
I am sorry I cannot provide a translation as my Chinese is poor. But thank you for your excellent translation of the most important point in the article.