替诺福韦在怀孕期的预防介入研究，以防止高度病毒血症妇

StephenW

Prospective interventional study of tenofovir in pregnancy to prevent vertical transmission of hepatitis B in highly viremic women

Sellier, Pierre O.; Maylin, Sarah; Berçot, Béatrice; Chopin, Dorothée; Lopes, Amanda; Simoneau, Guy; Evans, John; Delcey, Véronique; Bénifla, Jean-Louis; Simon, François; Bergmann, Jean-François
European Journal of Gastroenterology & Hepatology:
March 2017 - Volume 29 - Issue 3 - p 259–263
doi: 10.1097/MEG.0000000000000793

Abstract

Background: The risk of vertical transmission of hepatitis B virus (HBV) increases as maternal HBV DNA increase, despite serovaccination to newborns.

Methods: From 1 July 2012 to 1 January 2016, all pregnant women in Lariboisiere Hospital, Paris, France, with HBV DNA of 5 log10 IU/ml and above were administered tenofovir from week 28 of pregnancy until delivery. HBV DNA was measured at months 1, 2 of tenofovir and at delivery. The newborns were serovaccinated, tested for hepatitis B surface antigen, hepatitis B core antibody (HBcAb)±HBV DNA, and hepatitis B surface antibody (HBsAb) when aged 9 months, and then 24 months. This study was registered in http://www.ClinicalTrials.gov (NCT02039362).

Results: Thirty-one women gave birth to 37 newborns. Maternal HBV DNA at baseline was 8.23 log10 IU/ml and above in 12 pregnancies. The mean (median) HBV DNA were 4.4±1.2 (4.8), 3.3±1.7 (3.8), and 2.1±1.9 (2.0) log10 IU/ml at months 1, 2 of tenofovir and at delivery, respectively. Twenty-seven newborns were followed up: none of the 19 children aged 9 months or older was positive for hepatitis B surface antigen when aged 9 months; 14 children tested positive for HBcAb (probably transferred maternal antibodies, not found when aged 24 months) and for HBsAb without HBV DNA. Four of the 19 children showed HBsAb without HBcAb, the last being doubtful for HBcAb and HBsAb without HBV DNA. Eight newborns aged less than 9 months were not tested.

Conclusion: Tenofovir from week 28 of pregnancy to highly viremic HBV women plus serovaccination to newborns could prevent chronic and past infection.
Author Information

aInternal Medicine Department

bMicrobiology Department

cObstetrics Department, Saint-Louis/Lariboisiere-Fernand Widal Hospital, Paris, France

Correspondence to Pierre O. Sellier, MD, PhD, Internal Medicine Department, Saint-Louis/Lariboisiere-Fernand Widal Hospital, 2, Ambroise Paré Street 75475 Paris Cedex 10, France Tel: +33 149 956 339; fax: +33 149 956 340; e-mail: [email protected]

Received July 21, 2016

Accepted October 7, 2016

StephenW

替诺福韦在怀孕期的预防介入研究，以防止高度病毒血症妇女的乙型肝炎的垂直传播

Sellier，Pierre O.; Maylin，Sarah; Berçot，Béatrice;肖邦，多萝西洛佩斯Simoneau，Guy;埃文斯Delcey，Véronique; Bénifla，Jean-Louis;西蒙，弗朗索瓦Bergmann，Jean-François
欧洲胃肠病学与肝病学杂志：
2017年3月 - 第29卷 - 第3期 - 第259-263页
doi：10.1097 / MEG.0000000000000793
原创文章：肝炎

    抽象
    作者信息

抽象

背景：随着母亲HBV DNA增加，尽管对新生儿进行血清免疫接种，但乙型肝炎病毒（HBV）的垂直传播的风险增加。

方法：2012年7月1日至2016年1月1日，所有在法国巴黎Lariboisiere医院，HBV DNA为5 log10 IU / ml及以上的孕妇从妊娠28周开始给药替诺福韦。在替诺福韦的第1,2和在输送时测量HBV DNA。新生儿接受血清阳离子化，在9个月，24个月后测试乙型肝炎表面抗原，乙型肝炎核心抗体（HBcAb）±HBV DNA和乙型肝炎表面抗体（HBsAb）。这项研究在http://www.ClinicalTrials.gov（NCT02039362）中注册。

结果：31名妇女生下了37名新生儿。在12个妊娠中，基线时的母亲HBV DNA为8.23log10 IU / ml和以上。在替诺福韦和输送时第1,2和3个月，平均（中值）HBV DNA分别为4.4±1.2（4.8），3.3±1.7（3.8）和2.1±1.9（2.0）log 10 IU / ml。二十七个新生儿随访：19个9个月或以上的儿童中没有一个在9个月时对乙型肝炎表面抗原呈阳性反应; 14个儿童测试HBcAb阳性（可能转移母体抗体，在24个月时未发现）和无HBV DNA的HBsAb。 19名儿童中有4名显示无HBcAb的HBsAb，最后一个对HBcAb和HBsAb无HBV DNA的疑问。 8个月龄不到9个月的新生儿没有接受测试。

结论：替诺福韦从妊娠28周到高度病毒血症HBV女性加上新生儿的血清阳离子抗体可以预防慢性和过去的感染。
作者信息

内科

b微生物部

cObstetrics Department，Saint-Louis / Lariboisiere-Fernand Widal Hospital，Paris，France

联系人：Pierre O. Sellier，医学博士，医学博士，圣路易斯/ Lariboisiere-Fernand Widal医院，2，AmbroiseParé街75475 Paris Cedex 10，法国电话：+33 149 956 339;传真：+33 149 956 340;电子邮件：[email protected]

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