Li Duan, Xu De-Zhong, Choi Bernard C K, Men Ke, Zhang Jing-Xia, Lei Xiao-Ying, Yan Yong-Ping
Department of Epidemiology, Fourth Military Medical University, Xian, China.
J Med Virol. 2005 Jun;76(2):203-7. doi: 10.1002/jmv.20353.
Previous studies reported that the HBV DNA level in maternal serum is an important risk factor for intrauterine infection. Two antiviral drugs, lamivudine (3TC) and interferon alpha (IFNalpha), are used extensively clinically to reduce maternal HBV DNA level, However, because of a lack of evidence on the efficacy and safety of these drugs during pregnancy, they are categorized as grade C which prevents their use during pregnancy. This study provides new data on the efficacy and safety of lamivudine and IFNalpha in HBV positive transgenic pregnant mice. In this study, transgenic mice with high titers of hepatitis B virus (HBV) were employed to study the antiviral effects of 3TC and IFNalpha during different gestation periods. The study also examined changes in several serological HBV markers, the effects of perinatal exposure to antiviral drugs on the mother and offspring, drug efficacy in reducing the level of HBV DNA in maternal blood, and the safety to both the mother and offspring. The main conclusion of the study is that a significant decrease in HBV DNA level can be obtained after treatment with lamivudine but not with IFNalpha. No adverse effects were observed in the maternal mice and the offsprings. This finding may provide a rationale for the potential use of lamivudine for the treatment of pregnant women as a safe and effective measure to reduce the level of maternal viremia.
先前的研究报道,母血清中的乙肝病毒脱氧核糖核酸(HBV DNA)水平是宫内感染的一个重要危险因素。两种抗病毒药物,拉米夫定(3TC)和α干扰素(IFNα),在临床上被广泛用于降低母亲的HBV DNA水平。然而,由于缺乏这些药物在孕期疗效和安全性的证据,它们被归类为C级,这使得它们在孕期无法使用。本研究提供了拉米夫定和IFNα在HBV阳性转基因妊娠小鼠中的疗效和安全性的新数据。在本研究中,使用高滴度乙型肝炎病毒(HBV)转基因小鼠来研究3TC和IFNα在不同妊娠期的抗病毒作用。该研究还检测了几种血清学HBV标志物的变化、围产期接触抗病毒药物对母鼠和仔鼠的影响、药物降低母血中HBV DNA水平的疗效以及对母鼠和仔鼠的安全性。该研究的主要结论是,拉米夫定治疗后HBV DNA水平可显著降低,但IFNα治疗则不然。在母鼠和仔鼠中均未观察到不良反应。这一发现可能为拉米夫定作为一种安全有效的措施用于治疗孕妇以降低母血病毒血症水平提供理论依据。