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Written by: Chen Jiahui
2021-03-29 07:00
Last update date: 2021-03-29 07:00
If a baby is infected with hepatitis B virus through mother-to-child transmission without taking preventive measures, there is a 90% chance of becoming a chronic hepatitis B patient, and it is easy to develop into serious liver diseases such as liver cancer and cirrhosis.
The Hospital Authority has introduced new measures to provide additional first-line antiviral drug "tenofovir" for pregnant women suffering from hepatitis B and high levels of virus in their bodies to further reduce the risk of mother-to-child transmission during delivery.
All 10 public hospitals with obstetrics in Hong Kong have participated in the project.
Provide additional antiviral treatment for pregnant women with high viral load
More than half a million people (7.2% of the population) in Hong Kong are infected with hepatitis B virus. Mother-to-child transmission is particularly worthy of attention, because 90% of infected babies will develop chronic hepatitis and have a higher risk of developing liver cancer, cirrhosis and other serious liver diseases.
Liang Yongchang, director of the Department of Obstetrics and Gynecology of Guanghua Hospital, said that since 1988, all newborn babies need to be vaccinated, and if the mother is a hepatitis B patient, the baby needs to be injected with immunoglobulin. Measures can reduce mother-to-child transmission by 90% .
Liang Yongchang said that for families, this is not a question of ratio. Once the illness has a great impact, he hopes to "save one by one."
The Hospital Authority is adopting new measures to arrange for pregnant women to undergo hepatitis B viral load testing. If the number exceeds 200,000 international units, antiviral drug treatment will be arranged to further reduce low transmission.
Liang emphasized that antiviral drug treatment will go hand in hand with current measures.
Doctors who take antiviral drugs from the 28th week of pregnancy: do not increase the risk of pregnant women and fetuses
Lao Weixiang, a consultant physician in the Department of Internal Medicine of Eastern Hospital, said that the bureau uses the first-line commonly used drug "tenofovir", which has few and mild side effects, usually gastrointestinal discomfort, headache, rash, etc.; and past clinical data and experience show that it is taken during pregnancy , And will not increase the risk of pregnant women and fetuses.
He said that pregnant women who need treatment will also be referred to a nurse's clinic, where the nurse will explain the benefits and side effects of the treatment.
Lao Weixiang (first from right) said that the bureau uses the first-line commonly used drug "tenofovir". Past clinical data and experience show that taking it during pregnancy does not increase the risk of pregnant women and fetuses.
The first on the left is Dr. Leung Wing Cheong, acting consultant doctor Gao Junlong of the Quality and Safety Department of the Hospital Authority (middle) (photographed by Chen Jiahui)
Lao Weixiang pointed out that the treatment is generally scheduled to start around the 28th to 32nd week of pregnancy (the third trimester of pregnancy) to avoid the period of fetal organ formation and to ensure sufficient time to reduce the viral load during delivery to 200,000. Below the international unit.
Lao reminded that after delivery, pregnant women need to be evaluated by their doctors when to stop the drug, so as to avoid repetitive liver enzyme levels due to self-discontinuation.
Obstetrics in public hospitals in Hong Kong provide treatment
Gao Junlong, the acting consultant of the Quality and Safety Department of the Hospital Authority, said that starting from 2020, the plan will be implemented by Queen Mary Hospital and Prince of Wales Hospital in January last year. The remaining eight public hospitals with obstetrics have also been implemented in August last year. They have been participating in the plan one after another, that is, all public hospitals with obstetric departments in Hong Kong have participated in the plan.
In terms of the number of participants, Liang Yongchang pointed out that since the implementation of the plan, about 15,000 pregnant women have received this service in public hospitals. Based on the infection rate of 4%, that is, about 600 pregnant women are infected with hepatitis B, and about one in six (17%) are found. , That is, 100 people have a high viral load, and eight of them will be prescribed antiviral drugs by their doctors.
He said frankly that some pregnant women who are ill may have a conservative attitude towards taking medication and did not participate in the plan. He hopes that as the plan is implemented and education is strengthened, the participation rate will increase.
Gao Junlong (first from right), the acting consultant of the Quality and Safety Department of the Hospital Authority, said that Queen Mary Hospital and Prince of Wales Hospital first implemented the plan in January last year, and the remaining eight public hospitals with obstetrics have also started in August last year. Participating in the plan, that is, all public hospitals in Hong Kong with obstetrics have participated in the plan.
(Photo by Chen Jiahui)
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