在妊娠早期或早期停止抗病毒治疗的慢性乙型肝炎妇女的妊

StephenW

Int J Med Sci. 2020 Jan 1;17(2):170-175. doi: 10.7150/ijms.38410. eCollection 2020.
Pregnancy Outcome of Women with Chronic Hepatitis B who Discontinued Antiviral Treatment before or in the Early Pregnancy.
Gao X1, Duan X1, Cai H2, Hu Y3, Liu M3, Kang K3, Zhou M3, Fu D3, Yi W3.
Author information

1
    Department of General Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, China.
2
    Hepatology clinic, Beijing Ditan Hospital, Capital Medical University, Beijing, China.
3
    Department of Obstetrics and Gynecology, Beijing Ditan Hospital, Capital Medical University, Beijing, China.

Abstract

Background: The aim of this study was to describe biochemical, virological features and Mother-to child-transmission (MTCT) rate in chronic hepatitis B (CHB) women who stopped antiviral therapy before or in the early pregnancy. Methods: This was a single-center, retrospective study. Forty-three CHB women who stopped treatment before or in the early pregnancy and 103 CHB women with tenofovir disoproxil fumarate (TDF) treatment throughout pregnancy were enrolled. The virological and biochemical flares during pregnancy and postpartum period were studied. MTCT rates were also compared. Results: During pregnancy, ALT flares (43.9% vs 1.0%) and viral rebound (31.7% vs 0) were more common in women who stopped treatment (P<0.001). Postpartum ALT flares were less frequent in women with treatment than those stopped treatment (0 vs 6/35, P = 0.001). The birth defect rate in the mothers who stopped treatment did not statistically differ from that of mothers treated throughout pregnancy (4.9 % vs 3.9 %, P = 1.000). There were no significant differences of gestational complications between the two groups, except intrahepatic cholestasis of pregnancy (12.2% vs 0, P = 0.002). The rate of MTCT in mothers who discontinued treatment was higher (2.4% vs 0, P = 0.285), although there was no statistically significant. Conclusion: ALT flares were common in mothers who discontinued antiviral therapy. Thus, these pregnant women should be monitored closely. Cessation of treatment was not recommended although no hepatic failure was observed. Larger studies are needed to evaluate the safety of discontinuation before pregnancy.

© The author(s).
KEYWORDS:

alanine transaminase; antiviral agents; chronic hepatitis B; infant; pregnancy complications

PMID:
    32038100
PMCID:
    PMC6990883
DOI:
    10.7150/ijms.38410

StephenW

国际医学杂志2020年1月1日； 17（2）：170-175。 doi：10.7150 / ijms.38410。 eCollection 2020。
在妊娠早期或早期停止抗病毒治疗的慢性乙型肝炎妇女的妊娠结局。
高X1，段X1，蔡H2，胡Y3，刘M3，康K3，周M3，付D3，易W3。
作者信息

1
    首都医科大学附属北京地坛医院普通科，北京
2
    首都医科大学附属北京地坛医院肝病门诊，北京
3
    首都医科大学附属北京地坛医院妇产科，北京

抽象

背景：这项研究的目的是描述在怀孕前或怀孕早期停止抗病毒治疗的慢性乙型肝炎（CHB）妇女的生化，病毒学特征和母婴传播率。方法：这是一项单中心回顾性研究。纳入了在妊娠早期或妊娠早期停止治疗的43名CHB妇女和103名在整个妊娠期间接受替诺福韦酯富马酸二甲苯甲磺酸（TDF）治疗的CHB妇女。研究了妊娠和产后的病毒和生化爆发。还比较了MTCT发生率。结果：在怀孕期间，停止治疗的女性更容易出现ALT爆发（43.9％vs. 1.0％）和病毒反弹（31.7％vs 0）（P <0.001）。与接受治疗的女性相比，接受治疗的女性产后ALT发作的频率更低（0 vs 6/35，P = 0.001）。停止治疗的母亲的出生缺陷率与整个妊娠期间接受治疗的母亲的统计学差异无统计学差异（4.9％比3.9％，P = 1.000）。除妊娠肝内胆汁淤积（12.2％vs 0，P = 0.002）外，两组之间的妊娠并发症没有显着差异。终止治疗的母亲的MTCT发生率较高（2.4％vs 0，P = 0.285），尽管无统计学意义。结论：ALT发作在终止抗病毒治疗的母亲中很常见。因此，应密切监测这些孕妇。尽管未观察到肝功能衰竭，但不建议停止治疗。需要更大的研究来评估妊娠前停药的安全性。

©作者。
关键字：

丙氨酸转氨酶；抗病毒药慢性乙型肝炎婴儿;妊娠并发症

PMID：
    32038100
PMCID：
    PMC6990883
DOI：
    10.7150 / ijms.38410

StephenW

https://www.medsci.org/v17p0170.pdf