乙型肝炎表面抗原阳性的高病毒载量母亲在妊娠中期或晚期

StephenW

乙型肝炎表面抗原阳性的高病毒载量母亲在妊娠中期或晚期使用替比夫定的疗效和长期安全性：一项为期 10 年的前瞻性研究
姜红秀1、叶夏军、陈超、周冠伦、韩国荣
隶属关系
联系

    1
    【作者单位】： 南京中医药大学南京第二医院妇产科;

    PMID: 36227027 DOI: 10.1097/MCG.0000000000001779

抽象的

目标：本研究旨在评估替比夫定 (LdT) 对病毒载量高的乙型肝炎表面抗原 (HBsAg) 阳性孕妇的疗效和长期安全性。

背景：未从长期角度评估妊娠期间 LdT 的疗效和安全性。

研究： HBsAg 阳性孕妇被纳入并根据抗病毒起始时间分组。 A 组 (n=100) 和 B 组 (n=100) 在妊娠中期或晚期开始接受 LdT 治疗。 C组（n=90）未接受抗病毒治疗。比较了 LdT 治疗的疗效和安全性，并对婴儿进行了 1、5 和 10 年的随访。丹佛发育筛查测试在 5 岁时进行。

结果：LdT治疗组分娩前病毒载量低于C组，A组低于B组（P<0.001）。 LdT 治疗组中没有婴儿被感染，而 C 组中 8.8% (8/90) 的婴儿有 HBsAg 阳性 (χ2=23.20, P<0.001)。所有接受 LdT 治疗的母亲均耐受良好，未报告婴儿发生 LdT 相关不良事件。部分婴幼儿体格发育指标高于中国标准值（SV），并呈现显着差异。 A组和B组发育筛查合格率分别为100%（48/48）和97.96%（48/49），与中国正常儿童92%相比差异无统计学意义（χ2=5.72，P=0.06）。

结论：在妊娠中期开始的治疗可以加强母婴传播阻断的成功率。从长远来看，怀孕期间的 LdT 治疗对母亲和婴儿都是安全的。

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StephenW

  Efficacy and Long-term Safety of Telbivudine Usage During Second or Third Trimester in Hepatitis B Surface Antigen Positive Mothers With High Viral Load: A 10-year Prospective Study
Hongxiu Jiang  1 , Xiajun Ye, Chao Chen, Guanlun Zhou, Guorong Han
Affiliations
Affiliation

    1
    Department of Obstetrics and Gynecology, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, China.

    PMID: 36227027 DOI: 10.1097/MCG.0000000000001779

Abstract

Goals: The study is to evaluate the efficacy and long-term safety of telbivudine (LdT) usage for hepatitis B surface antigen (HBsAg) positive pregnant women with high viral load.

Background: The efficacy and safety of LdT during pregnancy were not assessed from a long-term perspective.

Study: HBsAg-positive pregnant women were enrolled and grouped according to antiviral initiation time. Group A (n=100) and group B (n=100) were treated with LdT initiated in the second or third trimester. Group C (n=90) received no antiviral treatment. The efficacy and safety of LdT treatment were compared and infants were followed-up at 1, 5, and 10 years. Denver developmental screening test was conducted at 5 years.

Results: Viral loads before delivery in LdT-treated groups were lower than that in group C and group A was lower than that in group B (P<0.001). No infants in LdT-treated groups were infected whereas 8.8% (8/90) infants in group C had positive HBsAg (χ2=23.20, P<0.001). All LdT-treated mothers were well tolerated and no LdT-related adverse events in infants were reported. Part of the physical growth index of infants was higher than Chinese standard values (SV) and showed significant differences. In groups A and B, the developmental screening test qualified rate of 100% (48/48) and 97.96% (48/49) showed no significant difference compared with 92% in normal Chinese children (χ2=5.72, P=0.06).

Conclusions: Treatment initiated during the second trimester could strengthen the success of mother-to-child transmission blockage. LdT treatment during pregnancy is safe for both mothers and infants in the long term.

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