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替比夫定治疗晚期妊娠可预防乙型肝炎病毒母婴传播:一项回顾性研究。

Telbivudine Treatment during Late Pregnancy Prevents Mother-to-Child Transmission of Hepatitis B Virus: A Retrospective Study.

机构信息

Center for Liver Diseases, Nantong Third People's Hospital, Nantong University, Nantong 226006, China.

Department of Obstetrics and Gynaecology, Affiliated Hospital of Nantong University, Nantong 226001, China.

出版信息

Can J Gastroenterol Hepatol. 2019 Jul 9;2019:9046260. doi: 10.1155/2019/9046260. eCollection 2019.

DOI:10.1155/2019/9046260
PMID:31380321
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6652084/
Abstract

PURPOSE

To investigate the efficacy of telbivudine (LdT) in blocking mother-to-child transmission (MTCT) of hepatitis B virus (HBV) during late pregnancy.

METHODS

A total of 651 pregnant women aged 18-40 in Nantong Third People's Hospital and Hospital affiliated to Nantong University with positive hepatitis B surface antigen (HBsAg) and HBV DNA were enrolled between January 2011 and December 2015. Patients with HBV DNA≥10 copies/mL (n=251) received LdT during late pregnancy according to the patients' will, while 136 high viral patients with HBV DNA≥10 copies/mL who did not take LdT therapy and 268 low viral patients with HBV DNA<10 copies/mL served as the controls.

RESULTS

At 7 months and 1 year postpartum, the basal HBV DNA serum level of treated patients declined significantly (<0.001), while no obvious decline was observed in the untreated high viraemic controls (<0.05) and untreated low viraemic controls (<0.05). Only 1 infant (0.4%) in LdT group was HBsAg positive at 7 months, while 14 (5.2%) were in the untreated low viraemic controls (<0.001) and 15 (11.0%) were in untreated high viraemic controls (<0.001).

CONCLUSION

For pregnant women with HBV DNA≥10 copies/mL, the use of LdT during late pregnancy could effectively reduce the MTCT rate of HBV.

摘要

目的

研究替比夫定(LdT)在妊娠晚期阻断乙型肝炎病毒(HBV)母婴传播(MTCT)的疗效。

方法

2011 年 1 月至 2015 年 12 月,共纳入南通第三人民医院和南通大学附属医院 651 例年龄 18-40 岁的 HBsAg 和 HBV DNA 阳性的孕妇。HBV DNA≥10 拷贝/mL 的患者(n=251)根据患者意愿在妊娠晚期接受 LdT 治疗,而未接受 LdT 治疗的 136 例高病毒载量患者(HBV DNA≥10 拷贝/mL)和 268 例低病毒载量患者(HBV DNA<10 拷贝/mL)作为对照组。

结果

产后 7 个月和 1 年,治疗组患者的基础 HBV DNA 血清水平显著下降(<0.001),而未治疗的高病毒载量对照组(<0.05)和未治疗的低病毒载量对照组(<0.05)无明显下降。LdT 组仅 1 例婴儿(0.4%)在 7 个月时 HBsAg 阳性,而未治疗的低病毒载量对照组有 14 例(5.2%)(<0.001),未治疗的高病毒载量对照组有 15 例(11.0%)(<0.001)。

结论

对于 HBV DNA≥10 拷贝/mL 的孕妇,妊娠晚期使用 LdT 可有效降低 HBV 的母婴传播率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c42/6652084/4846f4a303f9/CJGH2019-9046260.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c42/6652084/4846f4a303f9/CJGH2019-9046260.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c42/6652084/4846f4a303f9/CJGH2019-9046260.001.jpg

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Aliment Pharmacol Ther. 2019 Jan;49(2):211-217. doi: 10.1111/apt.15064. Epub 2018 Dec 2.
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Efficacy and safety of nucleos(t)ide analogues to prevent hepatitis B virus mother-to-child transmission in pregnant women with high viremia: real life practice from China.核苷(酸)类似物预防高病毒载量孕妇母婴传播乙型肝炎病毒的疗效和安全性:来自中国的真实实践。
Int J Med Sci. 2018 May 22;15(8):796-801. doi: 10.7150/ijms.25047. eCollection 2018.
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Speculation of the Time-Dependent Change of FIB4 Index in Patients with Nonalcoholic Fatty Liver Disease: A Retrospective Study.
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Can J Gastroenterol Hepatol. 2018 Mar 12;2018:5323061. doi: 10.1155/2018/5323061. eCollection 2018.
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Tenofovir versus Placebo to Prevent Perinatal Transmission of Hepatitis B.替诺福韦与安慰剂预防乙型肝炎围产期传播的比较
N Engl J Med. 2018 Mar 8;378(10):911-923. doi: 10.1056/NEJMoa1708131.
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Maternal viral load and hepatitis B virus mother-to-child transmission risk: A systematic review and meta-analysis.母体病毒载量与乙型肝炎病毒母婴传播风险:一项系统评价与荟萃分析。
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