PLoS One:来自南非的经验:对妊娠妇女产前HBV感染的快速筛查

2017-07-24 MedSci MedSci原创

背景和目的:目前消除HIV和梅毒的母婴传播(MTCT)受到很多关注,但是关于消除HBV的母婴传播关注度很低。在撒哈拉以南非洲地区,HBV垂直传播一直都是个重要的公共卫生问题。本研究旨在评估使用快速筛查(POC)测试筛选孕妇HBV感染情况的可行性,并进行母婴阻断的干预措施。

背景和目的:目前消除HIV和梅毒的母婴传播(MTCT)受到很多关注,但是关于消除HBV的母婴传播关注度很低。在撒哈拉以南非洲地区,HBV垂直传播一直都是个重要的公共卫生问题。本研究旨在评估使用快速筛查(POC)测试筛选孕妇HBV感染情况的可行性,并进行母婴阻断的干预措施。

方法:在这项观察性前瞻性队列研究中,非HIV感染的孕妇在知情同意后使用POC筛查HBsAg。筛查结果阳性的再进行HBV DNA和乙肝血清标记物进一步确诊。DNA载量≥20000 IU / ml的妇女接受替诺福韦(TDF)治疗,所有新生儿均接种乙肝疫苗。在新生儿出生后的第一年间隔6个月采集了两个血液样本用于检测HBV DNA。

结果:研究筛选了144名妇女,其中134名同意参加实验(93%接受乙肝病毒快速检测)。6例孕妇HBsAg检出阳性(4.5%; 95%CI:0.99%-8.01%),均经实验室检测进一步证实。2例妊娠妇女M1和M4在在孕晚期使用TDF治疗。6例HBV暴露的新生儿在出生后24小时内接种了乙肝疫苗,其中2例失访,4例(包括M1和M4出生的两例)在两个时间点进行测试时,HBV DNA均未检测到。

结论:我们发现使用POC测试筛查HBV感染可以满足筛查需求。它具有可接受性,便宜,可靠,并被受试者所接受。因此,可以作为筛选孕妇进行HBV母婴阻断预防策略的一部分,因此在南非临床中是可行的。

原始出处:Chotun N, Preiser W, van Rensburg CJ,et al. Point-of-care screening for hepatitis B virus infection in pregnant women at an antenatal clinic: A South African experience. PLoS One. 2017 Jul 21;12(7):e0181267. doi: 10.1371/journal.pone.0181267. eCollection 2017.

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    2018-04-30 klivis
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    2017-07-25 hongbochen
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    2017-07-25 qilu_qi
  6. [GetPortalCommentsPageByObjectIdResponse(id=1836629, encodeId=3c4e183662914, content=<a href='/topic/show?id=f9d08524be' target=_blank style='color:#2F92EE;'>#HBV#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8524, encryptionId=f9d08524be, topicName=HBV)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e87531, createdName=klivis, createdTime=Mon Apr 30 03:05:00 CST 2018, time=2018-04-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1790004, encodeId=db741e900044b, content=<a href='/topic/show?id=6e4814388e2' target=_blank style='color:#2F92EE;'>#Plos one#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14388, encryptionId=6e4814388e2, topicName=Plos one)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fda6311, createdName=119337457, createdTime=Fri May 11 12:05:00 CST 2018, time=2018-05-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1414428, encodeId=2efe14144280d, content=<a href='/topic/show?id=8e95364321f' target=_blank style='color:#2F92EE;'>#南非#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36432, encryptionId=8e95364321f, topicName=南非)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=83403055912, createdName=hongbochen, createdTime=Tue Jul 25 22:05:00 CST 2017, time=2017-07-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1462187, encodeId=1ac2146218e89, content=<a href='/topic/show?id=b97885350d' target=_blank style='color:#2F92EE;'>#HBV感染#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8535, encryptionId=b97885350d, topicName=HBV感染)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=33ed6479538, createdName=Tommy1951, createdTime=Tue Jul 25 22:05:00 CST 2017, time=2017-07-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1502507, encodeId=79a4150250e9b, content=<a href='/topic/show?id=ef4b2441971' target=_blank style='color:#2F92EE;'>#产前#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=24419, encryptionId=ef4b2441971, topicName=产前)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b49a9545081, createdName=qilu_qi, createdTime=Tue Jul 25 22:05:00 CST 2017, time=2017-07-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=225755, encodeId=fb06225e55b6, content=好文章,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Mon Jul 24 11:01:04 CST 2017, time=2017-07-24, status=1, ipAttribution=)]
    2017-07-24 1e0f8808m18(暂无匿称)

    好文章,学习了

    0

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