替比夫定或替诺福韦治疗的乙型肝炎e抗原阳性孕妇的临床疗

StephenW

Antivir Ther. 2020 Feb 12. doi: 10.3851/IMP3345. [Epub ahead of print]
Clinical efficacy and safety in telbivudine- or tenofovir-treated hepatitis B e antigen-positive pregnant women.
Deng H1, Liang S2, Xu M1, Zhuo L1, Gao H1, Chen K1, Shi Y1, Li H1, Jiao Q1, Lin L1, Lei Y1, Liu H1.
Author information

1
    Department of Infectious Diseases Center, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China.
2
    Community Health Service Center of Lin He Street, Guangzhou, China.

Abstract
BACKGROUND:

Telbivudine (LdT) and tenofovir (TDF) are widely used in pregnant women to prevent vertical transmission; however, limited data are available on the differences in clinical efficacy and safety between the two drugs.
METHODS:

A total of 307 hepatitis B e antigen (HBeAg)-positive pregnant women with complete follow-up data were enrolled, the patients with alanine aminotransferase (ALT) levels < 1*ULN at baseline were enrolled to cohort 1 for treated from 28 ± 4 weeks gestation to delivery, while ALT levels > 1*ULN at baseline were enrolled to cohort 2 for treated from 28 ± 4 weeks gestation and continued after delivery. The clinical efficacy and safety was compared in LdT- and TDF-treated patients. In addition, 32 patients in cohort 1 were analyzed for nucleoside analogues (NAs)-related resistance mutations at baseline and after delivery.
RESULTS:

The results showed that HBV DNA levels were significantly lower at delivery than at baseline (P<0.001), but the decreases in HBV DNA, ALT, TBIL and TBA levels did not differ between the LdT- and TDF-treated patients at different time points (P>0.05) in the two cohorts. However, gastrointestinal adverse effects (vomiting), occurred more frequently in TDF-treated than LdT-treated patients (6.6% vs. 0.0%, P=0.001). The results of NAs-related resistance mutations analysis in cohort 1 revealed that short-term LdT or TDF treatment did not significantly change the NAs-related resistance mutations (P>0.05).
CONCLUSIONS:

This study revealed that the clinical efficacy in LdT- or TDF-treated HBeAg-positive Chinese pregnant women is similar, and gastrointestinal adverse effects occurred more frequently in TDF-treated patients.

PMID:
    32049069
DOI:
    10.3851/IMP3345

StephenW

Antivir Ther。 2020年2月12日。doi：10.3851 / IMP3345。 [Epub提前发行]
替比夫定或替诺福韦治疗的乙型肝炎e抗原阳性孕妇的临床疗效和安全性。
邓H1，梁S2，徐M1，卓L1，高H1，陈K1，时Y1，李H1，焦Q1，林L1，雷Y1，刘H1。
作者信息

1个
    广州医科大学附属广州市第八人民医院感染科，广东广州。
2
    中国广州林河街社区卫生服务中心。

抽象
背景：

替比夫定（LdT）和替诺福韦（TDF）在孕妇中广泛使用，以防止垂直传播。然而，关于这两种药物在临床疗效和安全性方面的差异的可用数据有限。
方法：

纳入了具有完整随访数据的307名乙肝e抗原（HBeAg）阳性的孕妇，基线时丙氨酸氨基转移酶（ALT）水平<1 * ULN的患者入组了第1组，治疗率从28±4妊娠至分娩的第2周，而ALT水平> 1 * ULN在基线时被纳入第2组，从妊娠28±4周开始接受治疗，分娩后继续。比较了LdT和TDF治疗的患者的临床疗效和安全性。此外，对队列1中的32名患者在基线和分娩后进行了核苷类似物（NAs）相关的耐药性突变分析。
结果：

结果显示，分娩时HBV DNA水平显着低于基线水平（P <0.001），但在不同时间点接受LdT和TDF治疗的患者中，HBV DNA，ALT，TBIL和TBA的下降没有差异（P> 0.05）在两个队列中。然而，与LdT治疗的患者相比，TDF治疗的患者胃肠道不良反应（呕吐）的发生率更高（6.6％vs. 0.0％，P = 0.001）。队列1的NAs相关耐药突变分析结果表明，短期LdT或TDF治疗并没有显着改变NAs相关耐药突变（P> 0.05）。
结论：

这项研究表明，LdT或TDF治疗的HBeAg阳性中国孕妇的临床疗效相似，并且在TDF治疗的患者中胃肠道不良反应的发生频率更高。

PMID：
    32049069
DOI：