Newborn Hepatitis B

　　Neonatal infection with this disease is mainly caused by vertical mother-to-child transmission and horizontal transmission.

　　Firstly, mother-to-child transmission

　　The vertical transmission of mother-to-child transmission of hepatitis B specifically includes the following.

　　1. Transmission through the placenta: The mother is infected with hepatitis B during pregnancy or is a carrier of chronic hepatitis B, and can transmit the virus to the fetus.

　　2. Infection through the birth canal: Neonates are infected by swallowing the vaginal fluid containing hepatitis B at the time of delivery.

　　3. Infection through breast milk: Neonates are infected by being fed on the infected mother's milk.

　　4. Close contact after birth: Infected by contacting the saliva, colostrum, sweat, and blood secretions of the infected mother.

　　Secondly, horizontal transmission

　　Horizontal transmission is mainly through injection and transfusion of blood products. In addition, neonates can also be infected by contact with surrounding patients, carriers, and virus-contaminated substances after birth.

　　This disease often complicates with vitamin A and D deficiency. Some patients have a tendency to develop chronic hepatitis or liver cirrhosis, or may complicate with hepatic encephalopathy and hepatic failure, so early diagnosis and treatment should be given.

　　This disease has a slow onset, and most neonates are asymptomatic at birth. Neonatal hepatitis B is mainly manifested as jaundice, which can be manifested as delayed jaundice after birth, or recurrence after remission, or gradual deepening. Some cases may present with other clinical symptoms, such as fever, enlarged liver, poor appetite, which may recover or present as chronic hepatitis. Some patients may present with persistent obstructive jaundice, yellowing of the sclera and skin, darkening of urine like tea, deterioration or clay-colored stools, and enlargement of the liver and spleen. Most patients have no other clinical symptoms at birth, generally do not affect fetal development, are not teratogenic, and even have no changes in liver function and serology. A few cases present with an acute fulminant course, with the jaundice rapidly worsening after its onset, and developing into symptoms of hepatic encephalopathy, hemorrhage, and other signs of hepatic failure in a short period of time, with a poor prognosis.

　　Attention should be paid to the prevention of this disease. Hepatitis B vaccine should be administered once at birth, at the end of the first month, and at the end of the sixth month, with the dose varying according to different products. Reinforcement should be given every 5 years thereafter. For infants born to mothers in the acute or convalescent phase of hepatitis B, specific high-titer immunoglobulin (Hepatitis B Human Immunoglobulin, HBIG) should be used, which can significantly reduce the rate of hepatitis B virus carriage in infants. If only the vaccine is injected, the protection rate is about 70%. Currently, the trend is to use the combined injection method of hepatitis B vaccine and HBIG. If the above combined injection is adopted for infants of HBeAg-positive mothers, 95% of the infants can be protected.

　　The main methods of examination for this disease mainly include the following two:

　　1. Liver Function Test

　　During neonatal hepatitis, liver function may appear normal or only slightly abnormal. Serum alanine aminotransferase (ALT, i.e., GPT) begins to rise at the beginning of jaundice, peaks before the peak of serum bilirubin, and continues for several weeks after jaundice subsides. Serum bilirubin begins to rise at the end of the jaundice early stage.

　　2. Hepatitis B serum marker detection

　　The test shows that HBsAg can be positive.

　　The diet for neonatal hepatitis B patients should be high in sugar, calories, and protein, and low in fat. It should be quantitatively and定时, ensuring sufficient vitamins and fiber. During the acute phase, the diet should be light. Foods with therapeutic effects, such as wheat grass, pumpkin root, grapefruit, water chestnut, eel, tofu, clam,螺, bamboo shoot, sweet potato, chrysanthemum, Job's tears, clam, corn silk, celery, should be selected. Foods that improve liver function include eel, crucian carp, fish bladder, hairtail, lean pork, turtle, chrysanthemum, mushrooms, duck, sandworm, silver fish, rabbit meat, jujube, peanuts, rock sugar, etc., and can be eaten more in daily life. It is taboo to smoke and drink, and spicy, greasy foods.

　　For children with hepatitis, it is better to use simple drugs rather than complex ones to avoid damage to the liver from drugs.

　　First, Jaundice Treatment

　　The main drug used for jaundice is Yinzhi Huang.

　　Second, Immunomodulatory Drugs

　　In the treatment of this disease, immunomodulatory drugs such as thymosin and interleukin can be used.

　　Third, Antiviral Drugs

　　1. High-titer Immune GlobulinInjection of high-titer hepatitis B immune globulin extracted from human serum can effectively clear the hepatitis B virus and protect the exposed population.

　　2. Interferon (IFN)Currently, the most commonly used method is the subcutaneous injection of IFN-α 1 million U, changed to once every other day after continuous use for 1 week, with a course of 3 to 6 months to inhibit the replication of hepatitis B.

　　3. Lamivudine (Hepatoprotector)Lamivudine has a strong inhibitory effect on the hepatitis B virus but cannot clear the supercoiled DNA of the virus inside the liver cells. Short-term use followed by discontinuation is prone to rebound.