[肝胆速递] 围产期抗乙肝病毒治疗对孕妇防止肝功能衰

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围产期抗乙肝病毒治疗对孕妇防止肝功能衰竭的评估
Efficacy of peripartum antiviral treatment for hepatic failure due to hepatitis B virus

[肝胆速递] ：核苷药物可抑制乙肝复制，降低产妇死亡率并降少母婴传播概率。

http://www.ijgo.org/article/PIIS0020729211001688/abstract?rss=yes

Abstract
Objective
To investigate the efficacy of oral nucleosides in preventing hepatic failure during pregnancy (HFP) caused by hepatitis B virus (HBV) infection.

Methods
Besides receiving standard treatment, 70 women with HFP caused by HBV infection joined a study group (n=40) or a control group (n=30) according to their preference. In the study group, 14 women were given lamivudine in the third trimester and an antiviral treatment was continued postpartum. The 26 remaining patients were treated postpartum only, with lamivudine (n=16) or entecavir (n=10).

Results
In the study group, the values for serum HBV DNA and hepatitis B envelope antigen were markedly lower at 1 and 2months than they were at baseline (P<0.001 and P<0.001, respectively). Moreover, the HBV DNA values at 1 and 2months were significantly lower in the study than in the control group (P<0.05). Overall mortality and incidence of intrauterine infection were also significantly lower in the study group (P<0.05). No newborns had any apparent abnormalities in either group.

Conclusion
Treatment with nucleosides suppressed the replication of HBV DNA and led to biochemical improvement. It also reduced maternal mortality and safely decreased mother-to-child HBV transmission.













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