替诺福韦加乙型肝炎免疫球蛋白治疗导致高危孕妇的HBV DNA负

StephenW

Antivir Ther. 2018 Dec 20. doi: 10.3851/IMP3284. [Epub ahead of print]
Tenofovir plus hepatitis B immunoglobulin treatment resulted in a rapid HBV DNA load decline in high-risk pregnant women who missed the optimal time window of antiviral prophylaxis.
Chen T1, Liu J1, Yu Q2, Yao N1, Yang Y1, Wu Y1, Ren D1, Tian Z1, Zhao Y1, Wang J1,3.
Author information

1
    Department of Infectious Diseases, First Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an City, China.
2
    Department of Pediatric Surgery, Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an City, China.
3
    Department of Rheumatology, First Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an City, China.

Abstract
BACKGROUND:

Tenofovir disoproxil fumarate (TDF) administration in the third trimester for pregnant women with high HBV DNA load has been accepted as a wise practice to prevent mother-to-infant transmission (MTIT). However, for those women who missed the optimal time window of antiviral prophylaxis, the emergent treatment is lacked in the current clinical guidelines.
METHODS:

Forty-eight pregnant women who did not receive antiviral prophylaxis before 28 weeks of gestation were screened and were administrated with TDF plus hepatitis B immunoglobulin (HBIG, TDF+HBIG group) or TDF alone (TDF group). HBV DNA inhibition and the safety profile were compared between two groups.
RESULTS:

A decline of HBV DNA load was observed in both groups after the short period of treatment, and no infant had MTIT. However, compared to the TDF group, the speed of HBV DNA load decline was more rapid (P = 0.002) and a much more striking HBV DNA load decline in the first 4 week of treatment exhibited in the TDF+HBIG group (P = 0.001). The percentages of mothers with HBV DNA < 4 log10IU/mL and 3 log10IU/mL at delivery were both much higher in the TDF+HBIG group than the TDF group (P = 0.034 and 0.024, respectively). TDF and HBIG were found well-tolerated with no safety concerns in the mothers and their infants.
CONCLUSIONS:

TDF plus HBIG treatment resulted in a rapid HBV DNA load decline in high risk women who missed the optimal time window of antiviral prophylaxis in pregnancy, which potentially protected infants from HBV infection.

PMID:
    30570488
DOI:
    10.3851/IMP3284

StephenW

Antivir Ther。 2018年12月20日doi：10.3851 / IMP3284。 [提前打印]
替诺福韦加乙型肝炎免疫球蛋白治疗导致高危孕妇的HBV DNA负荷迅速下降，这些孕妇错过了抗病毒预防的最佳时间窗口。
Chen T1，Liu J1，Yu Q2，Yao N1，Yang Y1，Wu Y1，Ren D1，Tian Z1，Zhao Y1，Wang J1,3。
作者信息
抽象
背景：

妊娠晚期使用替诺福韦地索普西富马酸盐（TDF）治疗HBV DNA负荷高的孕妇已被认为是预防母婴传播（MTIT）的明智做法。然而，对于那些错过抗病毒预防的最佳时间窗的女性，目前的临床指南中缺乏紧急治疗。
方法：

筛选了48名未在妊娠28周前接受抗病毒预防的孕妇，并给予TDF加乙型肝炎免疫球蛋白（HBIG，TDF + HBIG组）或单独TDF（TDF组）。比较两组之间的HBV DNA抑制和安全性。
结果：

在短期治疗后，两组均观察到HBV DNA负荷下降，并且没有婴儿患有MTIT。然而，与TDF组相比，在TDF + HBIG组中，HBV DNA负荷下降速度更快（P = 0.002），治疗前4周HBV DNA负荷下降更为显着（P = 0.001） ）。分娩时HBV DNA <4 log10IU / mL和3 log10IU / mL的母亲的百分比在TDF + HBIG组中比TDF组高得多（分别为P = 0.034和0.024）。发现TDF和HBIG耐受良好，母亲及其婴儿没有安全问题。
结论：

TDF加HBIG治疗导致高风险女性的HBV DNA负荷迅速下降，这些女性错过了妊娠期抗病毒预防的最佳时间窗口，这可能保护婴儿免受HBV感染。

结论：
    30570488
DOI：
    10.3851 / IMP3284 rithm