[英语，老新闻]Telbivudine During Pregnancy Safely Reduces Perinatal HBV Tr

StephenW

http://www.thedoctorschannel.com/video/4294.html?specialty
NEW YORK (Reuters Health) – Perinatal transmission of hepatitis B virus from highly viremic mothers to their offspring is substantially reduced with telbivudine therapy during pregnancy, without any apparent adverse effects, a team in China has shown.

Dr. Guo-Rong Han and colleagues at the Second Affiliated Hospital of the Southeast University in Nanjing, explain in the Journal of Hepatology online April 18 that perinatal hepatitis B virus (HBV) infection is the main cause of chronic hepatitis B in the Asia-Pacific region.  While passive and active immunization given within 12 hours of birth can usually prevent transmission, the strategy fails in up to 15% of cases when maternal HBV DNA levels are high.

To assess the utility and safety of telbivudine in this setting, the researchers enrolled 229 mothers with HBV DNA levels greater than 10 million copies per mL in an open-label trial.  From gestational week 20 to week 32, 135 of the women received telbivudine 600 mg/day while 94 served as controls.

All the infants were given HBIg within 12 hours postpartum, and received HBV vaccine at 0, 1 and 3 months.

“Seven months after delivery, the incidence of perinatal transmission was lower in the infants that completed follow-up born to the telbivudine-treated mothers than to the controls (0% vs 8%; p=0.002),” Dr. Han and colleagues report.

Furthermore, the incidence and nature of adverse events were similar in the two groups, and none were considered to be drug related.

Based on the results, the authors conclude that telbivudine “should be recommended in pregnant women who are at high risk of transmitting HBV infection to their newborns.”

However, they add, “Additional randomized, multi-center, long-term follow-up studies are needed to better define the utility of telbivudine in preventing transmission.  The best timing for intervention with telbivudine should be further studied.”

Reference:
A prospective and open-label study for the efficacy and safety of telbivudine in pregnancy for the prevention of perinatal transmission of hepatitis B virus infection
J Hepatol 2011.   



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StephenW

纽约（路透社） - 乙肝从他们的后代高度病毒母婴传播的病毒血症的母亲是在怀孕期间大幅减少telbivudine治疗没有任何明显的不利影响，在中国队已经显示。

郭博士荣汉，在第二附属在南京东南大学附属医院，同事们解释了肝脏病杂志在线4月18日的围产期乙型肝炎病毒（HBV）感染是慢性乙肝在亚太地区的主要原因，亚太地区。虽然出生后12​​小时内通常可以预防传染给被动和主动免疫，孕产妇的战略失败时，HBV DNA水平高的可达15％的病例。

为了评估在此设置实用程序和替比夫定的安全性，研究人员招收更多的每毫升1000万份的开放标签试验229例HBV DNA水平的母亲。从妊娠20周复一周32岁的妇女时，接收135名作为对照组94替比夫定600毫克/天。

所有的婴儿产后12小时内给予乙肝免疫球蛋白，并收到0，1和3个月乙肝疫苗。

“七个月后交货，母婴传播的发生率比对照出生的替比夫定治疗的母亲已经完成后续婴儿低（0％比8％，p值= 0.002），”汉博士及其同事报告。

此外，发病率和不良事件的性质是相似的两组，没有被认为是与毒品有关。

根据研究结果，作者得出结论，替比夫定“应谁在传播乙肝病毒传染给新生儿的高风险孕妇的建议。”

但是，他们指出，“附加随机，多中心，长期随访研究来更好地确定预防传染的替比夫定的效用。对于替比夫定的干预的最佳时机应进一步研究。“

参考：
为替比夫定疗效和安全性的前瞻性和开放性研究在怀孕的乙肝病毒感染的母婴传播的预防
Ĵ肝脏病杂志2011年。