Clin Mol Hepatol. 2018 Jun 26. doi: 10.3350/cmh.2017.0082. [Epub ahead of print]
Effect of antiviral therapy in reducing perinatal transmission of hepatitis B virus and maternal outcomes after discontinuing them.
Seo KI1, Bae SH2,3, Sung PS2,3, Park CH2, Lee HL2, Kim HY2, Kim HJ2, Jang BH2, Jang JW2,3, Yoon SK2,3, Choi JY2,3, Park IY4, Lee J5, Lee HS5, Kim SJ4, Kwon JH2, Chang UI2, Kim CW2, Jo SH2, Young Lee YL4, Tekle F6, Kim JH5.
Author information
1
Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea.
2
Department of Internal Medicine, The Catholic University of Korea, Seoul, Korea.
3
The Catholic University Liver Research Centre and WHO Collaborating Centre of Viral Hepatitis, The Catholic University of Korea, Seoul, Korea.
4
Department of Obstetrics and Gynecology, The Catholic University of Korea, Seoul, Korea.
5
Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea.
6
Department of Gastroentrology and Hepatology, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
Abstract
Background/Aims:
There have been numerous efforts to reduce mother-to-child transmission (MTCT) of hepatitis B virus (HBV) with antiviral agents during pregnancy. However, there are limited data regarding the outcomes of pregnant women after delivery. This study was performed to evaluate the efficacy of antiviral agents in preventing MTCT of HBV and maternal long-term outcomes.
Methods:
The HBV-infected pregnant women treated with antiviral agents to prevent MTCT were retrospectively reviewed. Forty-one pregnant women who received telbivudine or tenofovir during late pregnancy (28-34 week) were analyzed. Hepatitis B virus surface antibody (HBsAb) positivity was tested in 43 infants after 7 months of birth. Eleven mothers were followed >1 year after delivery.
Results:
The mean HBV DNA titer before antiviral therapy was 8.67 (6.60-9.49) log copies/mL, and the median age at delivery was 32 years (range, 22-40). Eleven patients were treated with tenofovir and 30 with telbivudine. The median duration was 57 days (range, 23-100), and the median HBV DNA titer at birth was 5.06 log copies/mL (range, 2.06-6.50). Antiviral treatments were associated with significant HBV DNA reduction (P<0.001). Among 43 infants (two cases of twins), HBsAb was not detected in two, subsequently confirmed to have HBV infection. Biochemical flare was observed in two of 11 mothers followed >12 months, and an antiviral agent was administered.
Conclusions:
Antiviral treatment during late pregnancy effectively reduced MTCT. Long-term follow-up should be required in such cases. In addition, given that maternal biochemical flare occurred in 18% of mothers, re-administration of antiviral agents might be required.
KEYWORDS:
Antiviral agents; Hepatitis B virus; Postpartum; Pregnancy; Mother-to-child transmission
Clin Mol Hepatol。 2018年6月26日。doi：10.3350 / cmh.2017.0082。 [电子版提前打印]
抗病毒治疗在减少乙型肝炎病毒围生期传播和停药后的母亲结局方面的作用。
Seo KI1 Bae SH2,3 Sung PS2,3 Park CH2 Lee HL2 Kim HY2 Kim HJ2 Jang BH2 Jang JW2,3 Yoon SK2,3 Choi JY2,3 Park IY4 Lee J5 Lee HS5，Kim SJ4，Kwon JH2，Chang UI2，Kim CW2，Jo SH2，Young Lee YL4，Tekle F6，Kim JH5。
作者信息