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Simplified Criteria to Assess Long-Term Antiviral Treatment Indication in Chronic HBV-Infected Pregnant Women in Cambodia.

Authors :
Yang, Jee-Seon
Sovann, Saren
Shimakawa, Yusuke
Nhoueng, Sovann
Dim, Bunnet
Vong, Chanlina
Sann, Channa
Guillebaud, Julia
Vann, Darapolin
Touch, Bunrith
Chea, Hyna
Phirum, Wathanak Pisey Choupoan
Rosenthal, Eric
Paul, Christelle
Khun, Leangchhun
Yay, Chantana
Laurent, Denis
Chhun, Samsorphea
Borand, Laurence
Segeral, Olivier
Source :
Viruses (1999-4915); Feb2024, Vol. 16 Issue 2, p194, 12p
Publication Year :
2024

Abstract

Pregnant women identified to carry hepatitis B surface antigen (HBsAg) should be linked to care for the determination of the need for long-term antiviral therapy (LTT). We assessed the performance of simplified criteria, free from HBV DNA quantification, to select women eligible for LTT using different international guidelines as a reference. A retrospective analysis of HBV-infected pregnant women enrolled in the phase 4 ANRS TA-PROHM study was conducted in Cambodia. Sensitivity, specificity, and AUROC were computed to compare three simplified criteria (TREAT-B, HBcrAg/ALT, and TA-PROHM) with the American (AASLD) and European (EASL) guidelines as a reference. An additional assessment was performed at 6 months postpartum. Of 651 HBsAg-positive women, 209 (32%) received peripartum antiviral prophylaxis using tenofovir disoproxil fumarate (TDF). During pregnancy, 9% and 12% of women were eligible for LTT according to AASLD and EASL guidelines, respectively; 21% and 24% of women were eligible for prophylactic TDF and 2% and 5% in those ineligible (p < 0.001). Using the AASLD guidelines, the AUROC of TREAT-B, HBcrAg/ALT, and TA-PROHM scores were 0.88 (95%CI, 0.85–0.90), 0.90 (95%CI, 0.87–0.92), and 0.76 (95%CI, 0.73–0.80), respectively. Using the EASL guidelines, the AUROCs were lower: 0.73 (95%CI, 0.69–0.76), 0.76 (95%CI, 0.73–0.80), and 0.71 (95%CI, 0.67–0.74), respectively. Among those ineligible for prophylactic TDF, only 2% to 6% present an indication for LTT at 24 weeks postpartum. Few pregnant women are eligible for LTT, and the use of simplified criteria could represent an efficient triage option in decentralized areas to identify those negative for whom there is no urgent indication for LTT and focus on those positive for whom other exams must be conducted to confirm LTT indication. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
19994915
Volume :
16
Issue :
2
Database :
Complementary Index
Journal :
Viruses (1999-4915)
Publication Type :
Academic Journal
Accession number :
175649785
Full Text :
https://doi.org/10.3390/v16020194