Comparison of telbivudine versus lamivudine in interrupting perinatal transmission of hepatitis B virus.

BACKGROUND

Infection with hepatitis B virus (HBV) during pregnancy may lead to perinatal transmission.

OBJECTIVES

To compare the efficacy and safety of telbivudine versus lamivudine in interrupting perinatal transmission of hepatitis B virus.

STUDY DESIGN

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.

RESULTS

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.

CONCLUSIONS

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.