妊娠期乙型肝炎病毒感染者抗病毒治疗进展及争议

摘要

乙型肝炎表面抗原(HBsAg)阳性孕妇是否需要抗病毒治疗、如何治疗以及何时停止治疗需要结合孕母和胎儿情况综合考虑.孕期和孕母肝病病期是重要的考量因素.高病毒载量孕妇孕晚期的抗病毒治疗能够阻断母婴传播.现今,拉米夫定、替比夫定和替诺福韦都有充分的证据证实其在孕妇抗病毒治疗上的安全性.%All decisions about initiating,continuing,or stopping therapy of the hepatitis B virus (HBV) during pregnancy must include an analysis of the risks and benefits for mother and fetus.The trimester of the pregnancy and the stage of the mother's liver disease are important factors.Treatment in the third trimester may be initiated to aid in preventing perinatal transmission,which appears to be most pronounced in mothers with high viral loads.Currently,lamivudine,telbivudine and tenofovir appear to be the therapeutic options with the most reasonable safety data in pregnancy.