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Efficacy and safety of nucleos(t)ide analogues to prevent hepatitis B virus mother-to-child transmission in pregnant women with high viremia: real life practice from China.
- Source :
-
International journal of medical sciences [Int J Med Sci] 2018 May 22; Vol. 15 (8), pp. 796-801. Date of Electronic Publication: 2018 May 22 (Print Publication: 2018). - Publication Year :
- 2018
-
Abstract
- Purpose: To evaluate the efficacy and safety of nucleos(t)ide analogues, especially telbivudine (LdT) for the prevention of mother-to-child transmission (MTCT) of hepatitis B virus (HBV) in women with high viremia. Methods: We conducted a prospective, open-label, multicenter study of LdT for treating pregnant women having high viral loads of hepatitis B virus (HBV DNA>5 log <subscript>10</subscript> IU/mL) but normal levels of alanine aminotransferase (ALT). Maternal HBV DNA, HBV serologic status and ALT were measured at baseline, 4 weeks after therapy, before delivery, 4 weeks after delivery, and 12 weeks after delivery. Infant HBV serologic status and HBV DNA levels were measured at 7 months. We calculated the MTCT rate of LdT-treated and LdT-untreated groups and analyzed the efficacy and safety of LdT. Results: Ninety-one women (the treatment group) were treated with LdT, and twenty-one patients (the observation group) did not undergo antiviral therapy. The baseline HBV DNA levels were 8.15±0.82 log <subscript>10</subscript> IU/mL in the treatment group, and 8.09±1.04 log <subscript>10</subscript> IU/mL in the observation group. The MTCT rate was 0% in the treatment group, and 9.5% in the observation group (p=0.042). In the treatment group, HBV DNA levels were 5.02±0.74 log <subscript>10</subscript> IU/mL at one month after therapy, and 3.95±0.94 log <subscript>10</subscript> IU/mL before delivery. Both groups had significant differences from baseline levels in HBV DNA levels (p<0.001). In total, five patients had elevated ALT levels but without evidence of decompensate liver function. No severe adverse events or complications were observed in women or infants. Conclusions: For pregnant women with HBV DNA greater than 5 log <subscript>10</subscript> IU/mL, LdT therapy was effective in reducing HBV MTCT. If serum HBV DNA was detectable at delivery, discontinuation of LdT immediately was found to be safe and rarely induced off-treatment hepatitis flare.<br />Competing Interests: Competing Interests: The authors have declared that no competing interest exists.
- Subjects :
- Adult
Antiviral Agents
China
DNA, Viral
Female
Hepatitis B e Antigens
Hepatitis B virus
Hepatitis B, Chronic prevention & control
Humans
Infant, Newborn
Pregnancy
Pregnancy Complications, Infectious
Prospective Studies
Young Adult
Hepatitis B, Chronic transmission
Infectious Disease Transmission, Vertical prevention & control
Telbivudine therapeutic use
Viremia
Subjects
Details
- Language :
- English
- ISSN :
- 1449-1907
- Volume :
- 15
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- International journal of medical sciences
- Publication Type :
- Academic Journal
- Accession number :
- 30008589
- Full Text :
- https://doi.org/10.7150/ijms.25047