期刊
JOURNAL OF VIRAL HEPATITIS
卷 25, 期 4, 页码 429-437出版社
WILEY
DOI: 10.1111/jvh.12834
关键词
antiviral therapy; hepatitis B; mother-to-child transmission; pregnant women
资金
- National Key Clinical Research Project [2011271]
- Minister of Health of China
- Department of Science and Technology of Nanjing City [201402029]
- Science and Technology Development of Jiangsu Province [BL2012015]
- Jiangsu Provincial Department of Health [H201537, XK201607]
- Department of Science and Technology of Zhenjiang City [F22012047]
- Department of Science and Technology of Suzhou City, Jiangsu, China [SYSD2014025]
Infection of hepatitis B virus (HBV) occurs in similar to 10% of infants of HBV-infected mothers with positive hepatitis B e antigen (HBeAg) after immunoprophylaxis. We aimed to evaluate the safety and efficacy of telbivudine used during late pregnancy for preventing mother-to-child transmission of HBV. We conducted a multicenter prospective cohort study in 5 hospitals from 2012 to 2014, which enrolled HBV-infected singleton pregnant women with positive HBeAg. By their choice, women were divided into therapy (telbivudine 600mg/day, from gestation 28-32weeks to 3-4weeks postpartum) and control (no antiviral agent) groups. Infants received passive-active immunoprophylaxis and follow-up at the age of 7-14months. Totally, 328 pregnant women were included: 149 in the telbivudine group and 179 in the control group. Baseline HBV DNA levels were similar in the 2 groups (7.43 vs 7.37 log(10) IU/mL, P=.711). At delivery, HBV DNA levels in the telbivudine and control groups were 3.80 and 7.26 log(10)IU/mL, respectively (P<.0001). Of the infants, 128 (85.9%) in the telbivudine group and 156 (87.2%) in the control group were followed up. No infant in the telbivudine group had chronic infection, while 2 (1.28%) infants in the control group did (P=.503). Three (2.34%) infants in the telbivudine group, but none in the control group, had severe congenital or developmental abnormalities (P=.090). The data indicate that telbivudine may block perinatal HBV transmission. However, larger studies are required to clarify whether anti-HBV therapy in pregnancy is associated with severe adverse effects in the foetuses and infants.
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