替比夫定治疗慢性乙型肝炎的整个孕期的安全性

StephenW

J Viral Hepat. <http://www.ncbi.nlm.nih.gov/pubmed/> 2013 Apr;20 Suppl 1:65-70. doi: 10.1111/jvh.12066.

Safety of telbivudine treatment for chronic hepatitis B for the entire pregnancy.

Liu M
<http://cirrus.mail-list.com/hepatitis-b/77080660.html>, Cai H
<http://cirrus.mail-list.com/hepatitis-b/77663974.html>, Yi W
<http://cirrus.mail-list.com/hepatitis-b/99263986.html>.

Source

Department of Obstetrics and Gynecology, Beijing Ditan Hospital affiliated to Capital Medical University, Beijing, China.

Abstract

Orally administered nucleus(t)ide analogues (NA) have brought about a simple, safe and effective therapeutic approach for chronic hepatitis B (CHB). However, treatment duration is long and some female patients become pregnant during treatment. In recent years, there have been gradually increasing reports on the safety of telbivudine (LdT) treatment for chronic hepatitis B virus (HBV) infection in the third trimester of pregnancy to block mother-to-infant transmission (MTIT) of HBV; however, the safety of LdT treatment for chronic HBV infection for the entire pregnancy has not been reported. The aim of the present study was to evaluate the safety of LdT treatment for chronic HBV infection for the entire pregnancy and provide a reference for HBV-infected fertile women on how to block MTIT of HBV. Eighty-six pregnant women who received LdT treatment either before or in early pregnancy were enrolled in the study. Adverse events were prospectively observed for the entire pregnancy and perinatal period, and short-term and long-term follow-up of infants was conducted, monitoring the abnormalities of infants and blocking rate of MTIT with LdT treatment. Eighty-six pregnant women treated with LdT had a total of 89 pregnancies: 6 (6.7%) had early embryonic death or spontaneous abortion, 1 (1.1%) had ectopic pregnancy and three had a second pregnancy after initial abortion. Fifty-one mothers completed pregnancy: one had induction of labour at 24 weeks of pregnancy for cleft lip and palate of the foetus and 50 delivered 52 full-term live infants. One infant had right ear accessories, and the total occurrence of congenital abnormality was 3.8%. Thirty-nine infants were followed up for more than 6 months and completed all examinations for MTIT. None of the infants were HBsAg positive, resulting in a 100% success rate of blocking MTIT. All mothers maintained good liver function during the third trimester of pregnancy; 86% maintained complete virological response (HBV DNA <500 copies/mL) prior to delivery, and none developed progression of liver disease. Factors leading to increased adverse effects and drug resistance were not found. LdT treatment is safe and effective in chronic HBV-infected pregnant mothers for the entire pregnancy.

StephenW

北京地坛医院妇产科，系隶属于首都医科大学，北京，中国。


口服核（T）类似物（NA）治疗慢性乙型肝炎（CHB）带来了一种简单，安全，有效的治疗方法。然而，治疗持续时间很长，有些女性患者在治疗期间怀孕。近年来，有逐渐被越来越多的报告在孕晚期怀孕阻止母亲对婴儿的传输（MTIT）的HBV替比夫定（LDT）治疗慢性乙型肝炎病毒（HBV）感染的安全性，但是， LDT治疗慢性乙肝病毒感染的整个怀孕的安全还没有报道。本研究的目的是评价其安全性的LDT治疗慢性HBV感染整个孕期，上如何阻止MTIT的HBV HBV感染的育龄妇女提供了参考。 88个LDT治疗前或怀孕早期的孕妇参加了这项研究。整个孕期和围产期不良事件的前瞻性观察，短期和长期跟进的婴儿进行监测异常的婴儿和阻塞率MTIT LDT治疗。 88个孕妇治疗与LDT有一个总的89例妊娠早期胚胎死亡或自然流产6例（6.7％），1（1.1％），异位妊娠和第二次怀孕后最初流产。完成五十一的母亲怀孕：一个在妊娠24周引产胎儿和50交付了52足月活产婴儿唇颚裂的。一个的婴儿右耳配件，和先天性畸形的发生率为3.8％。三十九名婴儿随访6个月以上，并完成所有考试MTIT。没有婴儿HBsAg阳性，造成100％的成功阻止MTIT率。所有的母亲保持着良好的肝功能在孕晚期，86％，保持了完整的病毒学应答（HBV DNA <500拷贝/毫升）交付之前，并没有肝脏疾病的进展。导致增加的不利影响和耐药性的因素都没有发现。 LDT治疗慢性HBV感染的孕妇在整个怀孕的母亲是安全和有效的。

咬牙硬挺

这不是很多不良事件吗？

StephenW

回复 咬牙硬挺 的帖子

不高于一组没有乙肝的妇女.

咬牙硬挺

回复 StephenW 的帖子

说明环境污染很厉害啊，另外样本数量有点少，上千例有代表性