乙型肝炎病毒外膜大蛋白和HBVDNA血清学诊断价值

目的探讨乙型肝炎病毒外膜大蛋白和HBV-DNA在乙肝患者中的血清学诊断价值。方法收集乙肝两对半(HBV-M)中HBsAg阳性血清标本260例作为乙肝研究组,乙肝两对半(HBV-M)阴性血清标本100例作为正常对照组;在不同乙肝模式中采用酶联免疫吸附试验(ELISA)检测血清HBV-LP和Pre-S1,荧光定量PCR检测HBV DNA;比较HBeAg血清中HBV-LP与HBV-DNA和不同HBV-DNA拷贝数的条件下HBV-LP与HBV-DNA剂量关系。结果HBsAg阳性血清中HBV-LP、HBV-DNA和Pre-S1阳性率分别为68.46%、63.08%和24.23%;HBeAg阳性标本中HBV-LP、HBV-DNA和Pre-S1阳性率分别为94.87%、94.87%和79.49%;HBeAg阴性标本中HBV-LP、HBV-DNA和Pre-S1阳性率分别为62.64%、49.45%和0.55%,HBV-LP和HBV-DNA二者检出一致率为67.03%[(50+72)/182];HBV-LP吸光度(A值)与HBV DNA呈正相关。结论HBV-LP与HBV-DNA在HBeAg阳性血清中代表病毒复制具有较高检出一致率;HBV-LP与HBV-DNA在HBeAg阴性血清中具有较大的差异性,HBV-DNA阴性血清中检测HBV-LP反应乙肝病毒复制对乙肝抗病毒治疗更有重要意义;HBV DNA拷贝数与HBV-LP含量呈正相关系。     

乙肝病毒标志物在胎儿和胎盘组织中的表达及其与 HBV母婴传播关系的研究

目的通过对乙肝阳性产妇外周血、胎儿及胎儿附属物进行乙肝病毒标志物的检测,探讨HBV宫内感染发生的机制。方法通过ELISA法及实时荧光定量PCR法检测血清标本中HBV标志物及HBV DNA水平;通过对组织标本的免疫组织化学染色检测组织中HBV标志物的表达。结果胎儿脐血HBV DNA水平与母血HBV DNA水平相关,母血HBV DNA高水平(≥107copy/mL)时脐血HBV DNA阳性率明显增高,P<0.05。胎儿脐血HBV DNA水平显著低于母血HBV DNA水平,P<0.05。胎盘组织可见HBsAg免疫组织化学染色阳性,但未发现HBcAg染色阳性。在引产胎儿胎肝和胎肾组织中发现HBsAg和/或HBcAg免疫组织化学染色阳性细胞。结论母亲HBV DNA高水平是发生HBV宫内感染的高危因素。脐血HBV DNA阳性是判断HBV宫内感染的相关指标;HBV可能通过胎盘感染的途径由母体进入胎儿体内,并可能在胎儿体内定位和复制,这可能是导致HBV宫内感染的原因。     

HBV-DNA与乙型肝炎血清标志物的相关性分析

目的：探讨乙型肝炎病毒（HBV）DNA载量与其血清标志物的相关性。方法：运用荧光定量聚合酶链反应（FQ-PCR）、酶联免疫吸附实验（ELISA）分别检测503例患者HBV．DNA载量和HBV血清标志物。根据HBV血清标志物结果分为大三阳组、小三阳组、少见模式组、抗体阳性及全阴组,比较各组间HBV—DNA的阳性率及定量值。结果：在大三阳组、小三阳组、少见模式组、抗体阳性及全阴组HBV—DNA的阳性率分别为90％、65．1％、65．2％、2．0％,HBV—DNA的定量结果（10gHBV—DNA）别为6．32±1．96、2．01±1．68、3．48＋2．52f抗体阳性及全阴组阳性例数过低,不纳入统计）。大三阳组HBV—DNA的阳性率显著高于小三阳组（P〈0．05）。大三阳组、小三阳组HBV—DNA的阳性率与少见模式组比较,差异均无统计学意义（P〉0．05）,但大三阳组、小三阳组、少见模式组HBV．DNA的阳性率均显著高于抗体阳性及全阴组（P〈0．01）。HBsAg、HBeAg阳性组HBV—DNA的阳性率分别显著高于HB—sAg、HBeAg阴性组（P〈0．01）。小三阳组、少见模式组HBV．DNA载量均显著低于大三阳组（P〈0．01）,少见模式组HBV—DNA载量显著高于小三阳组（P〈0．05）。结论：HBV—DNA的阳性率与HBeAg、HBsAg相关;HBV—DNA栽量与HBV血清标志物模式相关。     

白细胞介素17 在妊娠合并乙肝中的表达

目的：观察白细胞介素17（Interleukin-17,IL-17）在乙肝孕妇和正常孕妇胎盘中表达差异来反映胎盘内的细胞免疫应答的情 况,为外源性细胞因子在增强机体免疫、清除病毒及阻断和治疗HBV宫内感染提供新的科学依据。方法：选择择期剖宫产的足月 妊娠妇女46 例,其中血清HBsAg（+）30 例,血清HBsAg（-）的对照组16 例,采用免疫组化方法检测胎盘组织IL-17 的表达。结 果：IL-17 主要表达在胎盘绒毛的合体滋养层细胞胞浆、毛细血管内皮细胞胞浆以及基质中。血清HBsAb（+）孕妇与HBsAb（-）孕 妇比较,无显著差异（P＞0.05）,HBsAg（+）乙肝孕妇与对照组的表达比较差异有统计学意义（P＜0.05）,HBeAg（+）孕妇与HBeAg （-）孕妇的表达比较差异有统计学意义（P＜0.05）。结论：IL-17 在乙肝孕妇胎盘组织中的表达高于正常孕妇,IL-17 的表达不但加 强了机体的防御功能,且能促进炎性反应。     

重庆地区乙肝血清特殊模式患者HBV基因分型及临床自然病程分析

目的了解重庆地区乙肝病毒（HBV）血清学标志物为特殊模式的HBV感染患者病毒基因型的分布情况,分析其临床特征及自然病程。方法从1000例HBV感染者中检测到48例乙肝病毒血清学标志物为特殊模式的患者（HBsAg与抗一HBs同时阳性,HBeAg与抗一HBe同时阳性）。采用巢式聚合酶链式反应（nPCR）对特殊模式患者的HBV进行基因分型,同时对两组特殊模式患者的临床资料和HBV感染的自然史进行分析。结果48例乙肝病毒血清学标志物为特殊模式的HBV感染者中,36例患者HBsAg与抗-HBs同时阳性,12例患者HBeAg与抗-HBe同时阳性。HBeAg＋／抗-HBe＋患者组的年龄较HBsAg＋／抗-HBs＋患者组的小（P〈0．05）。HBsAg＋／抗-HBs＋患者中,3例（8．3％）为B2亚型,12例（33．3％）为c2亚型,21例（58．4％）未分型;HBeAg＋／抗-HBe＋患者中,8例（66．7％）为B2亚型,1例（8．3％）为c2亚型,3例（25．0％）未分型,两组在HBV基因型的分布上差异具有统计学意义（Y2=17．44,P〈0．05）。在HBsAg＋／抗-HBs＋患者中,2例（4．2％）处于免疫清除期,14例（29．2％）处于低复制期,7例（14．6％）处于再活动期。HBeAg＋／抗-HBe＋患者中,5例（10．4％）处于免疫清除期。两组在HBV感染的自然病程中的分布差异具有统计学意义（X2=18．26,P〈0．05）。结论重庆地区乙肝病毒血清学标志物为特殊模式的慢性HBV感染者中,HBeAg与抗-HBe同时阳性的HBV感染者中B2亚型为优势基因型;HBsAg与抗-HBs同时阳性的HBV感染者中,HBV基因型以C2亚型为主。     

HBsAb标记胶体金探针对HBV阳性血清感染HPT-8细胞的示踪研究

目的:为临床诊断提供HBV进入HPT-8的依据。方法:HBV阳性血清(1.5×10~8拷贝/毫升)体外感染HPT-8细胞48h,设感染组、阴性对照组和空白对照组,ELISA检测细胞培养上清中HBsAg、HBeAg,提取感染后传代的各代细胞中DNA用于PCR检测HBV DNA。免疫荧光定量PCR检测细胞培养上清中HBV DNA的滴度。采用乙肝表面抗原单克隆抗体标记的胶体金探针对感染的HPT-8细胞中的乙肝表面抗原进行标记示踪。结果:ELISA检测感染组细胞第1、2代培养上清中HBsAg阳性,PCR检测感染组第1、2代细胞HBV DNA,结果均阳性。免疫荧光定量PCR检测感染组细胞上清在第1、2代、3代48h的HBV滴度分别为8×10~4、4.6×10~3、<10~3(拷贝/毫升)。通过胶体金探针的标记:乙肝表面抗原存在于感染细胞的溶酶体内、细胞膜和绒毛上。结论:血清中的HBV病毒能进入胎盘滋养细胞,并可从感染滋养细胞的树脂切片中获得乙肝表面抗原的超微结构定位。     

重组8型腺相关病毒介导HBV急性感染树鼩模型建立

目的利用重组8型腺相关病毒介导1.3拷贝HBV基因组（1.3HBV,ayw亚型）在树鼩肝脏表达,建立HBV急性感染树鼩模型。方法通过大腿内侧静脉注射将携带有1.3 HBV的重组8型腺相关病毒（recombi-nant adeno-associated virus 8,rAAV8-1.3HBV）导入树鼩肝脏,通过ELISA检测树鼩血清中HBsAg、HBeAg、HBsAb、HBeAb、HBcAb,荧光定量PCR检测树鼩肝脏和血清中HBV DNA,全自动生化分析仪检测血清中ALT水平,并观察感染后肝脏的病变情况。结果 HBV感染主要血清标志物1～2周内均检测阳性;30 d后肝组织仍可检测到病毒抗原阳性细胞;55 d时肝组织HBV DNA拷贝数仍可达到104～105;树鼩血清中HBV DNA拷贝数持续一个月高于正常组;肝组织炎细胞略增多,血清ALT水平持续升高。结论 rAAV8所携带的HBV基因组高效专一导入树鼩肝细胞并复制表达,成功建立HBV急性感染树鼩模型,为进一步探索rAAV8树鼩慢性感染模型打下一定的基础。     

乙肝病毒载量与血清标志物及ALT相关性研究

探讨了乙型肝炎病毒核酸(HBV-DNA)水平与乙型肝炎免疫标志物(HBVM)和丙氨酸氨基转移酶(ALT)的关系。分别采用实时荧光定量聚合酶链反应(FQ-PCR),酶联免疫法和连续监测法检测了345例血清标本HBV-DNA含量,HBVM(HBsAg、HBsAb、HBeAg、HBeAb、抗HBcIgM)表达及ALT水平。HBsAg、HBeAg(和抗HBcIgM)阳性患者HBV DNA阳性率要明显高于HBsAg、HBeAb(和抗HBcIgM)阳性患者、仅HBsAg阳性患者及HBsAb、HBeAb阳性患者(P<0.01)。血清HBeAg阳性标本HBV-DNA阳性率为98.7%,明显高于HBeAg阴性标本的61.6%(P<0.01),并且血清HBeAg阳性标本HBV-DNA含量(log值,7.42±1.43)也明显高于HBeAg阴性标本(4.36±1.73)(P<0.01);在HBV-DNA含量小于107copy/mL的标本中,ALT与HBV-DNA含量呈正相关(P<0.01)。血清中HBV DNA含量与乙型肝炎免疫标志物以及肝细胞损伤三者之间存在密切的关系,在临床工作中应对血清HBVM、ALT和HBV-DNA含量联合检测,这样才能更准确地判断患者病情、预后及指导抗病毒药物的应用。     

免疫预防阻断乙型肝炎病毒母婴传播效果的观察

阻断乙型肝炎病毒(HBV)母婴传播是控制乙型肝炎的重大问题。为探讨免疫预防对阻断HBV母婴传播的效果及影响因素,对667例HBV表面抗原(HBsAg)阳性孕妇及其婴儿进行研究。这些孕妇按HBVe抗原(HBeAg)和HBVDNA检测结果,分为HBeAg阳性组及阴性组、DNA阳性组及阴性组;按是否于孕晚期注射乙型肝炎免疫球蛋白(HBIG),分为注射组及未注射组。婴儿于出生24h内均肌内注射HBIG100IU,并按0、1、6方案注射10μg重组酵母HBV疫苗;8～12月龄后随访婴儿,并进行HBV标志物(HBV-M)检测。667个婴儿中,20例感染HBV,免疫阻断失败率为3.0%。孕妇HBeAg阳性组免疫阻断失败率为8.7%,阴性组为0.2%,两组差异显著(P<0.001);两组婴儿对疫苗免疫应答率分别为83.0%和83.1%,无显著差异(P=0.988)。孕妇DNA阳性组免疫阻断失败率为8.1%,HBVDNA均≥6log10copies/ml。孕期注射与未注射HBIG组婴儿免疫阻断失败率分别为3.7%和2.7%,无显著差异(P=0.479);两组婴儿对疫苗免疫应答率分别为84.4%和82.4%,无显著差异(P=0.519)。孕妇HBeAg阳性注射HBIG组与未注射组的免疫阻断失败率分别为8.4%和8.9%,无显著差异(P=0.892)。孕妇HBeAg阴性注射与未注射HBIG组的免疫阻断失败率分别为0.0%和0.3%,也无显著差异(P=0.538)。11例免疫阻断失败的婴儿中,10例出生时血清HBsAg已为阳性;8～12个月后随访,HBsAg仍持续阳性,提示为宫内感染。本研究证实,孕期注射HBIG未能提高婴儿对HBV疫苗加HBIG的免疫阻断效果。宫内感染可能是疫苗加HBIG免疫阻断失败的主要原因。采用降低孕妇血清HBVDNA的措施,如对孕妇进行抗HBV治疗,也许能降低HBV宫内感染率。     

比较不同血清型AAV携带HBV基因组建立乙肝小鼠模型效果

近年来,用8型腺相关病毒携带1.3拷贝HBV(Hepatitis B virus)基因组建立的HBV持续感染小鼠模型受到越来越多的关注。本研究比较了除AAV8之外的其他4种血清型重组腺相关病毒(Recombinant adeno-associated virus,rAAV)建立乙肝小鼠模型效果。首先,将携带1.3拷贝ayw亚型HBV基因组的1型、2型、5型、8型、9型腺相关病毒分别以1×10~(11) vg/只(Viral genome,vg)的剂量尾静脉注射C57BL/6J小鼠;利用ELISA方法监测小鼠血清中HBeAg和HBsAg表达水平;用定量PCR方法检测小鼠血清和肝脏中HBV DNA拷贝数;用免疫组化方法检测小鼠肝脏中HBc Ag的表达;用HE染色检测小鼠肝脏病理变化。结果显示,在持续8周中,5组小鼠血清中都检测到HBeAg和HBsAg的表达,血清和肝脏中均检测到HBV DNA的存在。HBeAg、HBsAg、HBV DNA表达水平高低依次为AAV8AAV9AAV1AAV5AAV2。5组小鼠用免疫组化方法都检测到肝脏中HBcAg表达,HE染色病理检测均观察到不同程度的肝损伤。本研究扩大了能用于建立乙肝小鼠持续感染模型可选择的AAV载体种类,发现虽然AAV1、2、5、9的建模效果不如AAV8,但它们都可以介导建立持续感染的乙肝小鼠模型,建模效果依次为AAV8AAV9AAV1AAV5AAV2。其中AAV9介导的建模效果与AAV8载体最为接近,可以替代AAV8载体用于有效地建立HBV持续感染的小鼠模型。     

Correlation between Vertical Transmission of Hepatitis B Virus and the Expression of HBsAg in Ovarian Follicles and Placenta

Background

The aim of this study was to investigate the correlation between the expression of hepatitis B surface antigen (HBsAg) in human ovary and placenta and the vertical transmission of hepatitis B virus (HBV).

Methodology/Principal Fidnings

Ovarian and placental tissue specimens of pregnant women infected with HBV were collected during cesarean section and immunostained for HBsAg. The sera of the corresponding newborns were tested for HBV markers and HBV DNA. HBsAg was detected in 15 out of 33 (45%) placental tissues and was further detected in capillary endothelial cells in 4 specimens (26%), of which 3 (75%) corresponding infants were infected with HBV in utero. Out of the 33 ovarian tissues, 7 (21%) were positive for HBsAg, of which 2 (28%) showed HBsAg in ovarian follicles and the 2 corresponding infants (100%) had intrauterine HBV infection.

Conclusions/Significance

HBsAg expression in cells of the ovarian follicle or placental capillary endothelium signal a higher risk for intrauterine HBV infection.     

病毒性肝炎HAV，HBV，HCV，HDV和HEV重叠感染的研究

采用ＥＬＩＳＡ法检测了１０８例乙型肝炎病毒（ＨＢＶ）感染者血清中的五种肝炎病毒──甲型（ＨＡＶ）、乙型（ＨＢＶ）、丙型（ＨＣＶ）、丁型（ＨＤＶ）和成型（ＨＥＶ）肝炎病毒的标志物,并采用ＰＣＲ技术检测了患者血清ＨＢＶＤＮＡ、ＨＣＶＲＮＡ及ＨＤＶＲＮＡ。结果五种肝炎病毒重叠感染者３５例（３２．４％）,单纯ＨＢＶ感染者７３例（６７．６％）。ＨＢＶ、ＨＡＶＭ重感染率为４．６％,ＨＢＶ、ＨＣＶ二重感染率为９．２％,ＨＢＶ、ＨＤＶＭ重感染率为１４．８％,ＨＢＶ、ＨＥＶ二重感染率为１．９％,ＨＢＶ、ＨＣＶ和ＨＤＶ三重感     

Peripheral Blood Mononuclear Cell Traffic Plays a Crucial Role in Mother-to-Infant Transmission of Hepatitis B Virus

The role of peripheral blood mononuclear cells (PBMCs) in HBV intrauterine infection is not fully defined. Particularly the origin of PBMCs in HBV-infected neonates remains to be addressed. We carried out a population-based nested case-control study by enrolling 312 HBsAg-positive mothers and their babies. PBMC HBV DNA as well as serum HBsAg and HBV DNA was tested in cohort entry samples. Totally, 45.5% (142/312) of the newborns were found to be infected with HBV in perinatal transmission. 119 mother-infant pairs were identified to be different in the genetic profile of maternal and fetal PBMCs by AS-PCR and hemi-nested PCR. Among them, 57.1% (68/119) of the maternal PBMCs in index cases were positive for HBV DNA while 83.8% (57/68) of the HBV DNA positive maternal PBMCs passed the placental barrier and entered the fetus. Furthermore, maternal PBMC HBV infection was significantly associated with newborn infants HBV infection. PBMC traffic from mother to fetus resulted in a 9.5-fold increased risk of HBV infection in PBMC HBV DNA positive newborn infants. These data indicate that maternal PBMCs infected with HBV contribute to HBV intrauterine infection of newborn infants via PBMC traffic from mother to fetus.     

Risk of vertical transmission of hepatitis B virus in Tunisia

The risk of vertical transmission of hepatitis B virus (HBV) varies with type of viral endemicity, degree of maternal infection and genomic characteristics of the virus. The aim of this study is to estimate this risk in Tunisia using serological and molecular methods to evaluate HBV replication, to determine viral genotypes and to detect presence of occult hepatitis in 2709 pregnant women. Serological markers were detected by ELISA methods, Genotype was determined by PCR-RFLP and occult hepatitis by nested-PCR. Four percent of women were positive for HBsAg; only 3% of them were also positive for HBeAg. Viral replication, over than 10(3) copies/ml, was detected in 61% of positive HBsAg patients. Three viral genotypes were detected: D (95%), B (3%) and A (3%). Occult hepatitis was detected in 4% of sera with "anti-HBc isolated" profile. In conclusion, the risk of vertical transmission of HBV exists in Tunisia. It increases by frequency of precore mutants, predominance of the genotype previously associated with high levels of replication and possibility of occult hepatitis B. These results show the importance of screening by serological HBV markers systematically during pregnancy with evaluation of viral replication in order to prevent vertical risk by efficient tools.     

Role of maternal viremia and placental infection in hepatitis B virus intrauterine transmission

The mechanism of intrauterine hepatitis B virus infection has not been established. In this study, venous blood, cord blood, and placental tissues from 171 chronic hepatitis B virus infected pregnant women were tested for hepatitis B surface antigen, hepatitis B core antigen, and hepatitis B virus DNA. We found that residence, mode of delivery, age, and number of gestational weeks of pregnant women were not correlated with intrauterine hepatitis B virus infection, while neonates of mothers who were hepatitis B s antigen positive and hepatitis B e antigen positive (P < 0.01) or who had high hepatitis B virus DNA levels (≥10⁶ copies/ml) were more likely to get an intrauterine infection (P < 0.01). The hepatitis B virus infection rate in placental cell layers gradiently decreased from the mother's side to the fetus's side of the placenta, but the odds ratio value of correlation between placental hepatitis B virus infection and intrauterine infection gradiently increased. The way of intrauterine hepatitis B virus infection may be through a layer–layer transmission pathway, although the possibility of placental leakage cannot be excluded.     

乙型肝炎病毒胎内传播的研究

为了探索HBV胎内感染的可能性及机率,随机配对选取了22例HBsAg携带者母亲的引产胎儿和22例HBsAg阴性母亲的引产胎儿,对其心血、肝脏进行了系统研究,简报如下: 1.对象 随机选择HBsAg阳性无症状带毒者的雷夫奴尔(Rivanol)引产胎儿22例,     

Prevalence of maternal cytomegalovirus (CMV) antibody and detection of CMV DNA in amniotic fluid.

The prevalence of cytomegalovirus (CMV) IgG antibody was determined in 573 pregnant women in the first trimester. The overall prevalence of CMV IgG antibody was 77.5%. The rate of seropositivity was 67.7% in women < 25 yr, and increased with age to 85.7% in women 40 yr. These results imply that young women in Japan are at increased risk for primary CMV infection during pregnancy and that congenital CMV infection rates might increase in the future. We conducted a prospective study of 75 pregnant women who underwent amniocentesis for various indications to determine if CMV DNA could be detected in the amniotic fluid. None had symptoms associated with CMV infection, CMV IgM antibody, or seroconversion to CMV IgG antibody during pregnancy. CMV DNA was not detected in the amniotic fluid using a polymerase chain reaction assay. The 65 fetuses, including 3 sets of twins, were followed through birth. CMV DNA was not detected in urine samples obtained within the first 2 weeks of life. In conclusion, CMV DNA was not detected in the amniotic fluid of women who did not have CMV infection. These results, however, suggest that the negative predictive value of prenatal amniotic fluid analysis is high and that the presence of CMV DNA in the amniotic fluid has clinical significance for the diagnosis of congenital CMV infection if detected in pregnant women.     

Association between the frequency of class II HLA antigens and the susceptibility to intrauterine infection of hepatitis B virus

Multiple factors determine the susceptibility to intrauterine hepatitis B virus (HBV) infection. These factors include the HBV structure, HBV mutation, HBV DNA level, placental barrier, the immune status of the mother, and the genetic make-ups of the newborn infants. Since HLA system is an integral component of the immune response, we hypothesized that the highly polymorphic HLA genes are the key determinants of intrauterine HBV infection. In this study, we selected newborn infants of HBsAg-positive mothers, and divided the infants into 2 groups: intrauterine infection group and non-intrauterine infection group according to the status whether or not they were infected at birth. Each infected infant was compared with 2 controls from the same birth cohort. HLA-DR allele typing was performed using a PCR-sequence specific primer (PCR-SSP) for 24 subjects with intrauterine infection and 48 controls without infection. We found that, among the fifteen (15) HLA-DR alleles assessed, HLA-DRB1*07 was the one, and the only one, significantly in excess (OR = 6.66, P = 0.004) in the intrauterine infection group compared to the non-intrauterine infection group. Our findings thus suggest that high frequency of HLA class II molecules, e.g. HLA-DRB1*07, is associated with the susceptibility of the infants to intrauterine HBV infection.     

乙型肝炎病毒携带孕妇母婴阻断的优化管理

我国是乙型肝炎病毒(Hepatitis B virus,HBV)感染的高流行区,HBV感染的育龄期女性是HBV传播的主要传染源,其中大多数育龄期的乙肝女性为乙型肝炎病毒携带状态,因此,乙型肝炎病毒携带孕妇的HBV母婴阻断成了临床愈发关注的问题。实践中,即使HBsAg阳性的孕妇分娩的新生儿接种乙肝疫苗和乙肝免疫球蛋白,仍有5%-10%的新生儿感染HBV,尤其母亲为HBe Ag阳性、高病毒载量者。因此,美国肝病研究学会(AASLD)、欧洲肝病学会(EASL)和英国国立优质卫生和保健研究所(NICE)指南推荐高病毒载量的孕妇在妊娠晚期口服抗病毒药物拉米夫定、替诺福韦、替比夫定进行母婴阻断,减少新生儿感染HBV的机率,但目前乙型肝炎病毒携带孕妇阻断HBV母婴传播的临床管理和预防策略尚未达成共识,尤其是母乳喂养和分娩方式等问题仍存在争议,本文谨从HBsAg筛查、垂直传播的危险因素、阻断方法、分娩方式、母乳喂养等方面进行综述,探讨如何优化管理乙型肝炎病毒携带孕妇,并对未来HBV母婴阻断的研究进行展望。