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Antivir Ther. 2018 Dec 20. doi: 10.3851/IMP3284. [Epub ahead of print]
Tenofovir plus hepatitis B immunoglobulin treatment resulted in a rapid HBV DNA load decline in high-risk pregnant women who missed the optimal time window of antiviral prophylaxis.
Chen T1, Liu J1, Yu Q2, Yao N1, Yang Y1, Wu Y1, Ren D1, Tian Z1, Zhao Y1, Wang J1,3.
Author information
1
Department of Infectious Diseases, First Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an City, China.
2
Department of Pediatric Surgery, Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an City, China.
3
Department of Rheumatology, First Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an City, China.
Abstract
BACKGROUND:
Tenofovir disoproxil fumarate (TDF) administration in the third trimester for pregnant women with high HBV DNA load has been accepted as a wise practice to prevent mother-to-infant transmission (MTIT). However, for those women who missed the optimal time window of antiviral prophylaxis, the emergent treatment is lacked in the current clinical guidelines.
METHODS:
Forty-eight pregnant women who did not receive antiviral prophylaxis before 28 weeks of gestation were screened and were administrated with TDF plus hepatitis B immunoglobulin (HBIG, TDF+HBIG group) or TDF alone (TDF group). HBV DNA inhibition and the safety profile were compared between two groups.
RESULTS:
A decline of HBV DNA load was observed in both groups after the short period of treatment, and no infant had MTIT. However, compared to the TDF group, the speed of HBV DNA load decline was more rapid (P = 0.002) and a much more striking HBV DNA load decline in the first 4 week of treatment exhibited in the TDF+HBIG group (P = 0.001). The percentages of mothers with HBV DNA < 4 log10IU/mL and 3 log10IU/mL at delivery were both much higher in the TDF+HBIG group than the TDF group (P = 0.034 and 0.024, respectively). TDF and HBIG were found well-tolerated with no safety concerns in the mothers and their infants.
CONCLUSIONS:
TDF plus HBIG treatment resulted in a rapid HBV DNA load decline in high risk women who missed the optimal time window of antiviral prophylaxis in pregnancy, which potentially protected infants from HBV infection.
PMID:
30570488
DOI:
10.3851/IMP3284 |
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