Li Xiao-Mao, Yang Yue-Bo, Hou Hong-Ying, Shi Zhong-Jie, Shen Hui-Min, Teng Ben-Qi, Li Ai-Min, Shi Min-Feng, Zou Ling
Department of Obstetrics and Gynecology, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510630, Guangdong Province, China.
World J Gastroenterol. 2003 Jul;9(7):1501-3. doi: 10.3748/wjg.v9.i7.1501.
To investigate the effect of hepatitis B virus (HBV) specific immunoglobin (HBIG) and lamivudine on HBV intrauterine transmission in HBsAg positive pregnant women.
Each subject in the HBIG group (56 cases) was given 200 IU HBIG intramuscularly (im.) every 4 weeks from 28-week (wk) of gestation, while each subject in the lamivudine group (43 cases) received 100 mg lamivudine orally (po.) every day from 28-wk of gestation until the 30(th) day after labor. Subjects in the control group (52 cases) received no specific treatment. Blood specimens were tested for HBsAg, HBeAg, and HBV-DNA in all maternities at 28-wk of gestation, before delivery, and in their newborns 24 hours before the administration of immune prophylaxis.
Reductions of HBV DNA in both treatments were significant (P<0.05). The rate of neonatal intrauterine HBV infection was significantly lower in HBIG group (16.1 %) and lamivudine group (16.3 %) compared with control group (32.7 %) (P<0.05), but there was no significant difference between HBIG group and lamivudine group (P>0.05). No side effects were found in all the pregnant women or their newborns.
The risk of HBV intrauterine infection can be effectively reduced by administration of HBIG or Lamivudine in the 3(rd) trimester of HBsAg positive pregnant women.
探讨乙型肝炎病毒(HBV)特异性免疫球蛋白(HBIG)和拉米夫定对HBsAg阳性孕妇HBV宫内传播的影响。
HBIG组(56例)的每位受试者从妊娠28周起每4周肌肉注射(im.)200 IU HBIG,而拉米夫定组(43例)的每位受试者从妊娠28周起每天口服(po.)100 mg拉米夫定,直至产后第30天。对照组(52例)的受试者未接受特殊治疗。在所有孕妇妊娠28周、分娩前以及其新生儿进行免疫预防前24小时采集血标本检测HBsAg、HBeAg和HBV-DNA。
两种治疗方法的HBV DNA均显著降低(P<0.05)。HBIG组(16.1%)和拉米夫定组(16.3%)的新生儿宫内HBV感染率显著低于对照组(32.7%)(P<0.05),但HBIG组和拉米夫定组之间无显著差异(P>0.05)。所有孕妇及其新生儿均未发现副作用。
对HBsAg阳性孕妇在妊娠晚期给予HBIG或拉米夫定可有效降低HBV宫内感染风险。