2021年宁夏回族自治区乙型肝炎母婴传播干预效果及其影响因素分析

常晶晶; 关健; 马睿

doi:10.3784/jbjc.202305160221

2021年宁夏回族自治区乙型肝炎母婴传播干预效果及其影响因素分析

Effect of intervention for preventing mother-to-child transmission of hepatitis B and influencing factors in Ningxia Hui Autonomous Region, 2021

摘要

摘要:
目的评价宁夏回族自治区（宁夏）乙型肝炎（乙肝）母婴传播阻断效果，并分析其主要影响因素。
方法对2021年宁夏乙肝表面抗原（HBsAg）阳性孕产妇所生儿童在出生后12 h内尽早注射乙肝免疫球蛋白（HBIG），并按照0-1-6月龄免疫程序完成全程乙肝疫苗（HepB）接种，全程HepB接种完成后1～2个月，采集儿童静脉血进行5项乙肝病毒血清标志物检测，开展免疫后血清学检测（PVST），并完成问卷调查。
结果 105 9例乙肝暴露儿童，首剂HepB及时接种率、HepB全程接种率、HBIG接种率、HBIG及时接种率分别为99.62%、100.00%、100.00%、99.72%；儿童HBsAg阳性率、乙肝表面抗体（HBsAb）阳性率分别为1.32%、92.07%。孕产妇乙肝e抗原（HBeAg）阳性是儿童发生母婴传播的危险因素［比值比（OR）=4.82，95%置信区间（CI）：1.50～15.47］；儿童月龄、孕产妇检测时期是影响儿童HBsAb阳性的主要因素，7～12月龄儿童HBsAb阳性率是12～18月龄儿童的3.83倍（OR=3.83，95%CI：2.36～6.21），孕早期和孕中期检测孕产妇所生儿童HBsAb阳性率分别是孕晚期检测所生儿童的4.56倍、3.51倍（OR=4.56，95%CI：2.77～7.50；OR=3.51，95%CI：1.64～7.53）。
结论 HepB和HBIG联合免疫模式对乙肝母婴传播干预效果好，需加强HBeAg阳性孕产妇及所生儿童的干预措施，及时对乙肝暴露儿童免疫效果进行监测评价。

Abstract:
Objective To evaluate the effect of preventing mother-to-child transmission of hepatitis B in Ningxia Hui Autonomous Region (Ningxia), and analyze the main influencing factors.
Methods Infants mothered by hepatitis B virus (HBV) surface antigen (HBsAg)-positive women in Ningxia in 2021 were injected with hepatitis B immunoglobulin (HBIG) as soon as possible within 12 hours after birth. After the completion of full course hepatitis B vaccination based on immunization schedule of 0-1-6 months. Venous blood samples were collected from the infants within 1–2 months for the detection of 5 serologic markers of HBV, and a questionnaire survey was conducted.
Results In 1 059 infants with vertical HBV exposure, the timely first dose vaccination rate and full dose vaccination rate against hepatitis B were 99.62% and 100.00%, respectively, and the injection rate of HBIG and timely injection rate of HBIG were 100.00% and 99.72%, respectively. The positive rates of HBsAg and hepatitis B surface antibody (HBsAb) in the infants were 1.32% and 92.07%, respectively. Mother being hepatitis B envelope antigen (HBeAg) positive was a risk factor for mother-to-child HBV transmission in the infants odds ratio (OR)=4.82, 95% confidence interval (CI): 1.50–15.47. Maternal testing time and infant's age were the main factors affecting HBsAb status in the infants. The positive rate of HBsAb in the infants aged 7–12 months was 3.83 times higher than that in the infants aged 12–18 months (OR=3.83, 95%CI: 2.36–6.21). The HBsAb positive rate in the infants born to mothers tested in the first and second trimesters was 4.56 times and 3.51 times higher than that in the infants born to mothers tested in the third trimester (OR=4.56, 95%CI: 2.77–7.50; OR=3.51, 95%CI: 1.64–7.53).
Conclusion Hepatitis B vaccination and HBIG injection have good effects on the prevention of mother-to-child transmission of hepatitis B. It is necessary to strengthen the intervention in HBeAg-positive pregnant women and their infants and monitor or evaluate the immunization effect in infants with vertical HBV exposure in time.

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