在B型肝炎病毒感染的妇女在怀孕期间停止抗病毒药物后的结

StephenW

Outcome after discontinuing antiviral agents during pregnancy in women infected with hepatitis B virus

Hee Yeon Kim    ,    Jong Young Choi email address    ,    Chung-Hwa Park    ,    Jeong Won Jang    ,    Chang Wook Kim    ,    Si Hyun Bae    ,    Seung Kew Yoon    ,    Jin Mo Yang    ,    Chang Don Lee    ,    Young Sok Lee

Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea

Received 24 September 2012; received in revised form 18 November 2012; accepted 26 November 2012. published online 02 January 2013.
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Abstract
Background

Women who are taking antiviral agents and become pregnant have several options that include, continuing therapy, ceasing drugs, or switching to safer drugs. However, there are limited data on the outcome in pregnant women after withdrawal of antiviral agents.
Objectives

We aimed to investigate the outcome of stopping antiviral agents in pregnant women with chronic hepatitis B virus (HBV) infection.
Study design

In this single-center, retrospective cohort study, 12 pregnant patients who had received antiviral therapy for HBV and cease drugs after awareness of pregnancy between 2003 and 2010 were enrolled. We retrospectively studied virologic and biochemical flares during pregnancy and postpartum period.
Results

Median age at pregnancy was 30.5 (range, 24–35) years, median duration of antiviral drug before pregnancy was 15.3 (range, 3.0–131.3) months, and median HBV DNA at withdrawal of therapy was 4.8 (range, 1.7–8.0) log10 copies/mL. Eight out of twelve patients (66.7%) had a viral rebound after stopping antiviral drugs during pregnancy. Severe hepatitis flares, defined as a 5-fold increase in serum alanine aminotransferase (ALT), were observed in six patients (50%) during pregnancy. However, all of these patients spontaneously recovered without an event of hepatic decompensation. High pretreatment ALT was associated with severe hepatitis flares after cessation of therapy during pregnancy. Five patients with at least 1-year treatment before pregnancy maintained low hepatitis activity after delivery.
Conclusions

Pregnant women with high pretreatment ALT or those treated less than 1 year before pregnancy have high risk of severe hepatitis flares after cessation of antiviral agents.

Abbreviations: HBV, hepatitis B virus, HBeAg, hepatitis B envelope antigen, ALT, alanine aminotransferase, GA, gestational age, YMDD, tyrosine–methionine–aspartic acid–aspartic acid

StephenW

谁是服用抗病毒药物和怀孕的妇女有几个选项，包括继续治疗，停止药物，或改用更安全的药物。不过，也有孕妇抗病毒药物停药后的结果在有限的数据。
目标

我们的目的是调查的结果，停止抗病毒药物与慢性乙型肝炎病毒（HBV）感染的孕妇。
研究设计

在这种单中心，回顾性队列研究，谁曾接受抗病毒治疗对HBV和停止药物后怀孕的意识在2003年和2010年之间的12个怀孕的患者入组。我们回顾性研究病毒学和生化耀斑，在怀孕期间和产后期。
结果

怀孕时的年龄中位数为30.5岁（范围24-35），抗病毒的药物在怀孕前的平均时间为15.3个月（范围3.0-131.3），并在撤出治疗HBV DNA中位数为4.8（范围1.7-8.0） log10拷贝/ mL。八出12例（66.7％）有一个病毒反弹后停止抗病毒的药物在怀孕期间。重症肝炎爆发，定义为血清谷丙转氨酶（ALT）增加5倍，在怀孕期间有6例（50％）。然而，所有这些患者自愈没有发生肝功能失代偿。严重的肝炎爆发在怀孕期间停止治疗后与治疗前ALT高。 5例在怀孕前至少1年的治疗保持低肝炎，活动后交付。
结论

孕妇在怀孕前与治疗前ALT或治疗的不到1年有严重的肝炎爆发后停止抗病毒药物的高风险。

咬牙硬挺

孕期全程服用替诺安全吗

StephenW

回复 咬牙硬挺 的帖子

在我个人看来，是安全的.

MP4

咬牙硬挺 发表于 2013-1-8 11:06
孕期全程服用替诺安全吗

我建议全程,包括母乳期间