Shang J, Wen Q, Wang C C, Liu K, Bai L, Tang H
Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
J Viral Hepat. 2017 Nov;24 Suppl 1:43-48. doi: 10.1111/jvh.12785.
The management of hepatitis B virus (HBV) infection in pregnancy is a unique issue. Telbivudine (LdT) is recommended to block HBV mother-to-child transmission (MTCT) in the third trimester. However, the safety of LdT treatment during the entire pregnancy for the long-term growth of infants is unclear. The aim of this study was to evaluate the efficacy and long-term safety of LdT for the entire pregnancy period. This retrospective cohort study included 40 pregnant women and 43 children from 2011 to 2017. The antiviral effects and maternal abnormalities were evaluated. In addition, adverse events regarding infants at delivery and HBV vaccination outcomes were recorded. The status of physical development in the children during follow-up was also evaluated. Among pregnant women, the rates of HBV DNA flare were 5.00% during pregnancy and 7.50% postpartum, and the HBeAg seroconversion rates were 7.50% during pregnancy and 7.50% postpartum. No severe maternal abnormalities were observed. Regarding the infants, no one was positive for HBsAg, and only one infant was negative for anti-HBs in children over 7 months of age. Furthermore, no birth defects or severe adverse events were observed at delivery, and 97.67% normal height and 93.02% normal weight in children were observed on follow-up until 5 years of age. In conclusion, LdT use for the entire pregnancy is both effective for treating pregnant women and blocking HBV MTCT. Moreover, LdT is safe for women and infants. Most importantly, the long-term follow-up indicated that LdT is safe and does not affect the growth of children.
妊娠期乙型肝炎病毒（HBV）感染的管理是一个独特的问题。推荐使用替比夫定（LdT）在妊娠晚期阻断HBV母婴传播（MTCT）。然而，LdT在整个孕期治疗对婴儿长期生长的安全性尚不清楚。本研究的目的是评估LdT在整个孕期的疗效和长期安全性。这项回顾性队列研究纳入了2011年至2017年的40名孕妇和43名儿童。评估了抗病毒效果和母亲的异常情况。此外，记录了分娩时婴儿的不良事件和HBV疫苗接种结果。还评估了随访期间儿童的身体发育状况。在孕妇中，孕期HBV DNA复发率为5.00%，产后为7.50%，HBeAg血清学转换率在孕期和产后均为7.50%。未观察到严重的母亲异常情况。对于婴儿，HBsAg均为阴性，7个月以上儿童中只有1名婴儿抗-HBs为阴性。此外，分娩时未观察到出生缺陷或严重不良事件，随访至5岁时，儿童身高正常率为97.67%，体重正常率为93.02%。总之，整个孕期使用LdT对治疗孕妇和阻断HBV母婴传播均有效。此外，LdT对母婴均安全。最重要的是，长期随访表明LdT安全且不影响儿童生长。
