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.
Can J Gastroenterol Hepatol. 2019 Jul 9;2019:9046260. doi: 10.1155/2019/9046260. eCollection 2019.
To investigate the efficacy of telbivudine (LdT) in blocking mother-to-child transmission (MTCT) of hepatitis B virus (HBV) during late pregnancy.
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.
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).
For pregnant women with HBV DNA≥10 copies/mL, the use of LdT during late pregnancy could effectively reduce the MTCT rate of HBV.
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。
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。
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)。
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。