怀孕期间的C型肝炎治疗:实践改变的时间
Karley Dutra1, Jonathan M Fenkel2
1Thomas Jefferson University Hospital, Department of Obstetrics and Gynecology.
American journal of obstetrics & gynecology MFM
|December 9, 2025
概括
在怀孕期间,使用直接作用抗病毒药物 (DAA) 可以安全有效地治疗C型肝炎病毒 (HCV) 感染. 这种方法为防止围产期传播和改善婴儿结果提供了关键的机会.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 产科 产科 产科 产科 产科
- 传染性疾病 传染性疾病
背景情况:
- 型肝炎病毒 (HCV) 感染对公众健康构成重大挑战,特别是在生育年龄的人群中.
- 目前的产科指南不建议在怀孕期间治疗HCV,因为直接作用抗病毒药物的安全性和有效性数据有限.
- 周产期HCV传播风险高达9%,暴露后婴儿随访率较低.
研究的目的:
- 评估DAA在怀孕期间治疗HCV感染的安全性和有效性.
- 为了突出怀孕作为一个最佳的窗口对HCV治疗,由于持续的患者参与护理.
- 为妇产科医生提供有关怀孕女性HCV治疗的共享决策的信息.
主要方法:
- 关于在怀孕期间使用DAA的最新证据的审查.
- 对孕妇与非孕妇成年人治愈率的分析.
- 对第二和第三季度以及通过母乳暴露的DAA暴露数据的评估.
主要成果:
- 越来越多的证据表明,DAA在怀孕期间对HCV治疗是安全和有效的,治愈率与非怀孕的成年人相似.
- 关于通过母乳接触DAA的数据有限但令人放心.
- 莱迪帕斯维尔/索福斯布维尔和索福斯布维尔/韦尔帕斯维尔是怀孕治疗最多的可用数据.
结论:
- 怀孕期间的HCV治疗是可行的,并建议,最好是在第二或第三个三个月开始.
- 共享决策至关重要,平衡治疗效益与DAA暴露数据.
- 多学科合作对于优化孕妇获得HCV治疗的机会至关重要.
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