erinatal Hepatitis B Prevention ProgramTX Department of：围产期乙型肝炎预防programtx部

《erinatal Hepatitis B Prevention ProgramTX Department of：围产期乙型肝炎预防programtx部》由会员上传分享，免费在线阅读，更多相关内容在教育资源-天天文库。

1、PerinatalHepatitisBPreventionProgramTXDepartmentofHealthServicesTrudyMurphy,MDPreventionBranchDivisionofViralHepatitisNCHHSTP/CDCMay11,2010ImmunoprophylaxisagainstHepatitisBVirusInfection05/11/2010PathwaysforTransmissiontoInfantsofHepatitisBVirusInfection//?///PrenatalPerinatalPostnatal

2、05/11/2010RatesofSymptomaticandChronicHBVInfectionbyAgeatInfectionAgeatinfectionAcuteHBV(symptomatic)ChronicHBV<1year<1%90%1–5years5–15%25-50%>5years20–50%6–10%McMahonBJJInfectDis1985;151:599EdmondsWJProcRSocLondBBiolSc1993;253:197HyamsKC.ClinInfectDis1995;20:992Whatisimmunoprophylaxis?A

3、formofpost-exposureprophylaxis(PEP)usinghepatitisBvaccineandhightiterhepatitisBimmuneglobulin(HBIG)topreventperinatalandpostnataltransmissionofhepatitisBvirusinfectionHepatitisBinfectionhasalongincubationperiod*betweenexposureanddisease;provides“window”forprotectingagainstinfection05/11/

4、2010*90days[range60-150days]05/11/2010RiskofPerinatalHBVTransmissionVariesbyDegreeofVirusReplicationamongPregnantWomenwithChronicInfectionHBsAg=HepatitisBsurfaceantigen,markerofacuteorchronicinfection(infectious)HBeAg=HepatitisBeantigen,markerofhighlevelactiveHBVreplication(highlyinfect

5、ious)SerostatusofMother%InfantsInfectedHBsAgPositivePositiveHBeAgPositiveNegative70%-90%Highestrisk5%-20%Lowerrisk05/11/2010OverviewACIPrecommendationsforimmunoprophylaxistopreventperinatalhepatitisBinfectionHepatitisBvaccinesforinfantsSafetyEfficacywithandwithoutHBIGEfficacyinpreterminf

6、antsRevaccinatingnon-responders05/11/2010CaseManagementtoPreventPerinatalHBVInfection-1(Post-exposureProphylaxis-PEP)IdentifyallHBsAg-positivewomenandcasemanagetheirinfantsEnsuretheirinfantsreceivehepatitisBvaccineandHBIG≤12hoursofbirthSituationA-HighestRiskInfants05/11/2010CaseManageme

7、nttoPreventPerinatalHBVInfection-2(Post-exposureProphylaxis-PEP)CompletetherecommendedprimaryseriesofhepatitisBvaccineBW>2000gm:3-4totaldosesofhepatitisBvaccineBW≤2000gm(preterminfants):4totaldoseshepatitisBvaccine05/11/2010CaseManagementtoPreventPerinatalHBVInfections-