【摘要】 目的探讨母乳喂养对HBV母婴传播的影响。方法2002年1月—2004年12月江苏地区HBsAg阳性的281例孕妇及其子女,其中30.2%孕妇乙肝病毒e抗原阳性。婴儿母乳喂养222例,人工喂养59例。所有儿童均接种过乙肝疫苗,37.0%同时注射HBIG。2009年10月—2010年3月随访采血,检测HBV血清学标志。结果母乳喂养组和人工喂养组孕妇年龄、分娩方式,儿童年龄、性别比及HBIG注射情况差异均无统计学意义(P>0.05)。281例儿童中,HBsAg阳性和乙肝表面抗体阳性分别为3.2%和58.0%。人工喂养组和母乳喂养组HBsAg阳性率分别为5.1%和2.7%(P>0.05),进一步比较85例乙肝病毒e抗原阳性母亲的子女感染情况,两组孕妇HBVDNA水平相近(2.285×106 Vs 2.350×106,P>0.05),人工和母乳喂养的儿童HBsAg阳性率分别为11.1%(3/27)和10.3%(6/58),差异无统计学意义(P>0.05)。结论慢性HBV感染母亲的婴儿经免疫预防后,母乳喂养并不增加HBV母婴传播风险。因此,新生儿注射HBIG和乙肝疫苗后,医务人员应鼓励包括HBeAg阳性在内的HBV感染产妇进行母乳喂养。更多还原

【Abstract】 Objective To clarify whether breastfeeding of infants adds risk for the mother-to-child transmission of hepatitis B virus(HBV).Methods Totally 281 HBsAg-positive pregnant women,in whom 30.2% were also HBeAg-positive,and their 281 infants born from 2002 to 2004,were investigated from October 2009 to March 2010.HBV serologic markers were tested by ELISA and HBV DNA was quantified by real-time PCR.Of the 281 children,222 were breastfed and 59 formula-fed.All children had been vaccinated against hepatitis B and 37.0% received hepatitis B immunoglobulin(HBIG).Results The pregnant women’s age,delivery mode,children’s age,gender ratio,and administration of HBIG in infants were comparable between breast-and formula-feeding groups(P>0.05).The overall prevalence of HBsAg-positive and anti-HBs in the children was 3.2% and 58.0% respectively.In formula-and breast-fed children,the HBsAg-positive rates were 5.1% and 2.7% respectively(P>0.05).Further comparison of HBV infection in children of the 85 HBeAg-positive mothers showed that formula-and breast-fed children(27 and 58 respectively) had comparable HBsAg-positive rate(11.1% Vs 10.3%,P>0.05),while their mothers had similar HBV DNA levels(2.285×10 6 Vs 2.350×10 6,P>0.05).Conclusion With the currently available immunoprophylaxis,breast-feeding of infants born to chronic HBV carriers,add no risk for the mother-to-infant transmission of HBV.Therefore,with administration of HBIG and hepatitis B vaccine, HBV-infected mothers should be encouraged to breastfeed their infants.更多还原