Mother-infant Transmission Of Hepatitis B Virus Immunization Strategy Evaluation

BackgroundChina is the high prevalence area of hepatitis B virus(HBV),chronic hepatitis B virus(HBV)infection of about 120 million,the majority of people infected throμgh mother to infant transmission,to develop into hepatitis B virus carriers,chronic hepatitis,hepatecellular carcinoma, Liver become a new source of infection.Mother to infant transmission of the hepatitis B virus epidemic in the very important position.Prevention of neonatal HBV infection can significantly reduce the incidence of serious liver disease,thus greatly reducing the burden on society and family.Hepatitis B virus prevention of hepatitis B vaccine so far the most effective and economical way,but for HBV surface antigen(HBsAg)carriers in the mother's high-risk neonatal and perinatal single infant immunization with hepatitis B vaccine failure rate＞20%.In many countries and regions,for HBsAg carriers born to mothers of newborns to prevent perinatal transmission HBV,hepatitis B immunoglobulin been widely used and the hepatitis B vaccine with a joint immunization hepatitis B virus carriers to block the new mother Child perinatal transmission. ObjectivesAt present the domestic application of hepatitis B immune globulin is still a lack of guidance programmes,reported around the effects of hepatitis B immunoglobulin surviving controversy.Throμgh systematic evaluation, comparison of different national hepatitis B immunization strategy to prevent mother to infant transmission of the results,to develop a more rational and effective immunization strategy to provide some clues.Material MethodsIn this study,Meta-analysis methods.Major steps:1.Identify subjects, 2.Document Retrieval,3.Literature screening,4.Documentation and Information Extraction,5.Statistical analysis,with the effect of the merger,the heterogeneity of Qtest,Impartial assessment,the sensitivity analysis.This study used Rev4.2 software for statistical analysis.Main ResultsA total of 29 independent research into the meet this criteria and standards removed.Main results:①prenatal application of hepatitis B immunoglobulin group and the group should not use the neonatal hepatitis B virus infection merger statistics,from the RR and the corresponding 95%CI was 3.10(2.33～4.14),P value of less than 0.00001,Statistical significance。Subgroup analysis by the merger and its value RR 95%CI were:mother HBsAg and HBeAg-positive is the double-3.36(2.38 to 4.74), single HbsAg positive is 3.11(1.55～5.86),P value of less than 0.00001, the two Group results were statistically significant。②postpartum birth only after inoculation of hepatitis B vaccine group and the inoculation of hepatitis B vaccine of hepatitis B immunoglobulin and the Joint Group of neonatal hepatitis B virus infection merger statistics,from the RR and the corresponding value of 95%CI 1.98(1.52～2.58),P value of less than 0.00001,statistical significance.Subgroup analysis by the merger and its value RR 95%CI were:5μg doses of hepatitis B vaccine is 2.41 (1.68 to 3.46),10μg doses of hepatitis B vaccine is 1.78(1.16 to 2.73), two P＜0.00001,The results were statistically significant;mother HBsAg and HBeAg-positive is the double-2.66(1.74 to 4.05),single HbsAgpositive is 2.29(1.53 to 3.43),two P＜0.0001,the results are statistically significant.③postpartum birth after only 5μg inoculation of hepatitis B vaccine dose group and 10μg dose of neonatal hepatitis B virus infection merger statistics,from the RR and the corresponding value of 95%CI for the fixed effect model is 4.37(2.74 to 7.74),P＜0.001,the results are statistically significant;random effects model is 2.54(0.80～8.09), P value:0.11,the result was not significant.ConclusionThroμgh this research,access to the main conclusions are:①pregnant women carriers of hepatitis B virus pregnant 28 weeks,32 weeks,36 weeks dose of 200 IU of hepatitis B immunoglobulin fetus in the uterus can reduce the risk of infection.②the latter part of pregnancy should not be used hepatitis B immunoglobulin lead to intrauterine infection,the mother of hepatitis B virus HBsAg and HBeAg double-positive mothers than single-HbsAgpositive hepatitis Bvirus more dangerous.③pregnant women carriers of hepatitis B virus newborn,adopted by the hepatitis B vaccine of hepatitis B immunoglobulin joint immunization,to better prevention of perinatal hepatitis B virus infection.④non-economic conditions,the use of full immunization of 10μg dose of hepatitis B vaccine,but also better prevention of neonatal perinatal infection.