Yu Min-Min, Jiang Qian, Ji Ying, Wu Kai-Hua, Ju Li-Li, Tang Xun, Yang Yong-Feng
Department of Obstetrics and Gynecology, Second Affiliated Hospital of Southeast University, Nanjing 210003, China.
Department of Obstetrics and Gynecology, Yixing People's Hospital, Yixing 214200, China.
J Clin Virol. 2014 Sep;61(1):55-60. doi: 10.1016/j.jcv.2014.06.005. Epub 2014 Jun 13.
Infection with hepatitis B virus (HBV) during pregnancy may lead to perinatal transmission.
To compare the efficacy and safety of telbivudine versus lamivudine in interrupting perinatal transmission of hepatitis B virus.
All pregnant women enrolled in this study were positive for hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg). Test patients underwent antiviral therapy with telbivudine or lamivudine while control patients received hepatitis B immune globulin (HBIG) injection.
Patients in the telbivudine group had significantly lower HBV DNA and HBeAg levels and higher HBV DNA negative conversion rates compared to those in the lamivudine group before delivery. HBV DNA negative conversion rates in patients with abnormal alanine aminotransferase (ALT) levels were significantly higher than those in patients with normal ALT levels in the telbivudine and lamivudine groups before delivery. The intrauterine HBV infection rate and the percentage of immunization failure were both 0% in the telbivudine and lamivudine groups (χ(2)=0, 0; P=1, 1 respectively), compared to both 5% in the HBIG group (χ(2)=11.83, 7.86; P=0.002, 0.009 respectively). The side effects of three groups in mother and child were all unobvious.
Telbivudine and lamivudine can reduce HBV DNA levels in pregnant women, interrupt the vertical transmission of HBV and be used safely in mothers and children.
孕期感染乙型肝炎病毒(HBV)可能导致围产期传播。
比较替比夫定与拉米夫定阻断HBV围产期传播的疗效和安全性。
本研究纳入的所有孕妇乙型肝炎表面抗原(HBsAg)和乙型肝炎e抗原(HBeAg)均为阳性。试验患者接受替比夫定或拉米夫定抗病毒治疗,而对照患者接受乙型肝炎免疫球蛋白(HBIG)注射。
与拉米夫定组相比,替比夫定组患者分娩前的HBV DNA和HBeAg水平显著降低,HBV DNA阴转率更高。替比夫定组和拉米夫定组中,分娩前丙氨酸氨基转移酶(ALT)水平异常的患者的HBV DNA阴转率显著高于ALT水平正常的患者。替比夫定组和拉米夫定组的宫内HBV感染率和免疫失败率均为0%(χ²分别为0、0;P分别为1、1),而HBIG组均为5%(χ²分别为11.83、7.86;P分别为0.002、0.009)。三组母婴的副作用均不明显。
替比夫定和拉米夫定可降低孕妇的HBV DNA水平,阻断HBV垂直传播,且母婴使用安全。