一项实时的前瞻性研究表明，对于具有高HBV病毒载量的孕妇

StephenW

Infect Drug Resist. 2019 Nov 7;12:3475-3484. doi: 10.2147/IDR.S228982. eCollection 2019.
Early Start Of Tenofovir Treatment Achieves Better Viral Suppression In Pregnant Women With A High HBV Viral Load: A Real-World Prospective Study.
Gao F1, Zhang WT2, Lin YY2, Wang WM2, Xu N2, Bai GQ2.
Author information

1
    Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, People's Republic of China.
2
    Department of Gynecology and Obstetrics, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, People's Republic of China.

Abstract
Purpose:

To investigate whether tenofovir disoproxil fumarate (TDF) treatment that started from the second trimester had an advantage over TDF treatment that started from the third trimester.
Patients and methods:

Twenty 35-year-old pregnant women with hepatitis B virus (HBV) DNA >2×106 IU/mL were prospectively enrolled in this study. All participants were divided into two subgroups: the second trimester group who started TDF treatment at 24-27 weeks and the third trimester group who started TDF treatment at 28-30 weeks. The primary outcome was the change in serum HBV DNA level from baseline to delivery. Each parameter was tested every 4 weeks from TDF initiation to 3 months postpartum.
Results:

There were 80 pregnant women in the second trimester group and 49 pregnant women in the third trimester group. The decline in HBV DNA from baseline to delivery was more obvious in the second trimester group (4.8±1.2 log10 IU/mL) than that in the third trimester group (4.3±1.1 log10 IU/mL, p=0.041). The downward shift of haemoglobin (HB) from baseline to delivery was greater in the second trimester group (10.6±10.7 g/L) than in the third trimester group (6.3±12.3 g/L, p=0.041). The decline in HBV DNA from baseline to delivery was linearly related to the start of TDF treatment from the second trimester (β=0.50 and 95% CI: 0.26-0.75, p<0.001). There were no significant differences between the two groups regarding HBV serologic markers and safety indicators.
Conclusion:

Starting TDF treatment from the second trimester achieved better viral suppression than starting TDF treatment from the third trimester in highly viraemic pregnant women without increasing additional adverse reactions. HB level needed frequent monitoring during treatment to avoid anaemia.
Registry number:

Clinical Trial No. NCT02719808.

© 2019 Gao et al.
KEYWORDS:

efficacy; safety; second trimester; tenofovir disoproxil fumarate; third trimester

PMID:
    31807036
PMCID:
    PMC6844215
DOI:
    10.2147/IDR.S228982

StephenW

感染抗药性。 2019十一月7; 12：3475-3484。 doi：10.2147 / IDR.S228982。 eCollection 2019。
一项实时的前瞻性研究表明，对于具有高HBV病毒载量的孕妇，尽早开始使用替诺福韦治疗可获得更好的病毒抑制效果。
高F1，张WT2，林YY2，王WM2，徐N2，白GQ2。
作者信息

1个
    西安交通大学附属第一医院临床研究中心，陕西西安710061
2
    西安交通大学附属第一医院妇产科，陕西西安710061

抽象
目的：

为了研究从孕中期开始的替诺福韦富马酸二甲氧萘磺酸酯（TDF）治疗是否优于从孕晚期开始的TDF治疗具有优势。
患者和方法：

前瞻性研究了20名35岁以上乙型肝炎病毒（HBV）DNA> 2×106 IU / mL的孕妇。所有参与者分为两个亚组：第二个中期组在24-27周开始TDF治疗，第三个中期组在28-30周开始TDF治疗。主要结果是血清HBV DNA水平从基线到分娩的变化。从TDF开始到产后3个月，每4周测试一次每个参数。
结果：

孕中期组有80名孕妇，孕晚期组有49名孕妇。妊娠中期组HBV DNA从基线到分娩的下降（4.8±1.2 log10 IU / mL）比妊娠晚期组（4.3±1.1 log10 IU / mL，p = 0.041）更为明显。在妊娠中期组中，血红蛋白（HB）从基线向下转移的幅度更大（10.6±10.7 g / L），在妊娠中期组中（6.3±12.3 g / L，p = 0.041）。 HBV DNA从基线到分娩的下降与妊娠中期开始TDF治疗呈线性相关（β= 0.50和95％CI：0.26-0.75，p <0.001）。两组在HBV血清学指标和安全指标方面无显着差异。
结论：

在高病毒血症孕妇中，从妊娠中期开始进行TDF治疗比从妊娠晚期开始进行TDF治疗具有更好的病毒抑制作用，而没有增加其他不良反应。 HB水平需要在治疗期间经常监测以避免贫血。
注册表编号：

临床试验号NCT02719808。

©2019 Gao等。
关键字：

功效;安全;中期；替诺福韦富马酸替索罗非酯;孕晚期

PMID：
    31807036
PMCID：
    PMC6844215
DOI：
    10.2147 / IDR.S228982

StephenW

https://www.dovepress.com/getfile.php?fileID=53840