Author: Yang Fuheng, Maternal and Child Health Hospital of Guangdong Pharmaceutical Society Zhuhai City
In the previous article, the popular science mainly described when "Big and Little Sanyang" should start treatment and can choose antiviral treatment drugs. The following will introduce some doubts about accidental pregnancy in drug treatment, how to choose after the medication of hepatitis B mothers, and passive-active-active-activeKnowledge of hepatitis B virus immunity.
What should I do if I accidentally get pregnant in the treatment of hepatitis B drug?
The Guidelines for Prevention and Control of Chronic Hepatitis B (updated in 2015) pointed out that patients with accidental pregnancy during antiviral treatment: For example, interferon α treatment: It is recommended to terminate pregnancy.Because interferon has adverse effects on embryonic development, it is recommended to stop the drug and wait until the drug is discontinued for more than 6 months before pregnancy.
Such as applying oral nucleoside (acid) drugs:
1) If you are applied to pregnancy B -level drugs for Babidin or Norofovir ester, you can continue to treat it if you fully communicate and weigh the advantages and disadvantages;
2) If you apply the pregnancy C -class nucleoside drug (Ercavir or Lamifding), in the case of fully communicating and weighing the advantages and disadvantages, you need to use the pregnancy B -level drug to continue treatment, which can continue your pregnancy.
It is said that "the medicine can’t stop", what situation can stop the medicine?Can you breastfeed?
Many hepatitis B mothers have doubts.I heard that once antiviral drugs start taking medicine, it cannot be stopped. It is very dangerous if he stopped drugs to relapse hepatitis.
In addition, because oral antiviral drugs are not recommended, breastfeeding is not recommended. Postpartum mothers of hepatitis B also have such doubts about the discontinuation of antiviral drugs.
If you want to correctly understand this problem, you must first clarify the purpose of taking antiviral drugs.
There are usually two cases of antiviral drug medication schemes. Summary in Table 3:
Table 3 Comparison of antiviral medication schemes
Will hepatitis B mothers transmit hepatitis B to the baby?
Figure 2 Pathage of Hepatitis B virus transmission
The path of hepatitis B can be seen in Figure 2. Although hepatitis B can spread through maternal and infants, with the advancement of medicine, as long as the pre-pregnancy, pregnant, and after pregnancy takes appropriate prevention measures for virus transmission, such as newborns passive-active hepatitis B virus virusImmune prevention and effective antiviral treatment of mothers can significantly reduce the incidence of maternal and baby transmission.
Even women carrying hepatitis B virus can give birth to healthy babies who are not infected.
Hepatitis B mother and baby communication focuses on prevention. Zhuhai Maternal and Child Health Hospital, as the city’s prevention of "hepatitis B" maternal and infant communication project management units, is responsible for project management and technical guidance in the city.At present, it is actively preparing to start the launch of the zero -maternal and baby communication project of hepatitis B to achieve the future without hepatitis B.
my country’s 2015 "Guidelines for Prevention and Control of Chronic hepatitis B" pointed out that the passive-active BC virus immunity of newborns after childbirth, that is, the blocking solution of hepatitis B immunoglobulin combined with hepatitis B vaccine. The protection rate for infants can reach 70%-90 %.The following introduces the passive-active hepatitis B virus immunity of the newborn after childbirth.
Passive of newborns after childbirth-active hepatitis B virus immunity
For newborns of hepatitis B surface antigen (HBSAG) positive mothers, the muscle injection of hepatitis B immunoglobulin (dose ≥100IU) should be injected within two weeks within two weeks of birth within 24 hours after birth (preferably 12 hours after birth).branch,
Newborns should also be vaccinated in accordance with the "0, 1, 6 scheme" within 24 hours, and vaccination, that is, "birth at birth, 1 month after birth, and 6 months after birth".
When the newborn is born 2 months and 7 months, he also needs to check the "two pairs and a half" and hepatitis B virus DNA to understand whether the baby’s hepatitis B immunity is successful.
After the newborn injection of hepatitis B immunoglobulin and hepatitis B vaccine within 12 h, it can accept the breastfeeding of the hepatitis B antigen -positive mother.
Positive father who is positive for hepatitis B surface antigen (HBSAG) has intimate contact with newborns. In order to reduce the probability of neonatal infection, it is also recommended that newborns’ muscle injection of hepatitis B immunoglobulin within 24 hours after birth.
Summary
· During the treatment of drug treatment, you should consult a doctor or pharmacist to recommend that the specific situation should be analyzed.
· At present, the incidence of maternal and infant communication in hepatitis B is high, but its mechanism is not completely clear.The current prevention and control measures have reached a consensus:
1. The newborn of each HBSAG -positive mother gave birth to the main -passive joint immunity as soon as possible after birth.
2. Pregnant women with high-load (≥2 × 106IU/ml) for hepatitis B surface antigen (HBSAG) and hepatitis B anti-(HBEAG) dual-positive or hepatitis B virus DNA high load (≥2 × 106IU/ml) can acceptDerbidino Norofir antiviral treatment is used to increase the blocking rate.
· Postpartum medication needs to distinguish prevention and treatment of medication according to the patient’s personal conditions, and use medicine to use medicine and discontinue drugs.
Doctors and patients need to work together
Strive for the future without hepatitis B
The picture comes from the Internet. Thank you for the picture author. The variety involving manufacturers is for learning, understanding and use, and does not represent a recommendation position!
Review expert: Wang Li/Li Zhendong, Maternal and Child Health Hospital of Guangdong Pharmaceutical Society
The above is the original work of the "Drug Safety Cooperation Alliance" volunteer. If you reprint, please indicate the author and source!
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