Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, Department of Infectious Diseases, The Second Affiliated Hospital, Chongqing Medical University, No.1, Yixue Road, Yuzhong District, Chongqing, 400016, China.
Department of Cardiovascular Medicine, The Second Affiliated Hospital of Xi'an Jiaotong University (Xibei Hospital), Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Hepatol Int. 2020 May;14(3):338-346. doi: 10.1007/s12072-020-10024-2. Epub 2020 Mar 4.
Hepatitis B is a serious global health problem. Mother-to-child transmission (MTCT) of hepatitis B virus (HBV) is a major risk factor in the endemicity of HBV infection. Oral antiviral drugs are recommended to highly viremic mothers to decrease MTCT of HBV. The present network analysis compared the efficacy of available treatments to prevent the MTCT of HBV.
The electronic databases of PubMed, Embase, Web of Science, Scopus, and Wanfang data were searched for eligible studies. Pair-wise meta-analysis and Bayesian network analysis were applied to compare the efficacy of antiviral drugs.
Seventy-five studies involving 12,740 pregnant females were eligible for analysis. On pair-wise analysis, lamivudine (OR 0.15, 95% CI 0.09-0.25, I-squared = 0%), telbivudine (OR 0.07, 95% CI 0.05-0.10, I-squared = 0%) and tenofovir (OR 0.07, 95% CI 0.04-0.13, I-squared = 0%) significantly decreased the MTCT rate. Results of multiple comparisons with ranking probability based on Bayesian analysis showed that tenofovir (SUCRA = 96.83%) appeared more effective than the two other drugs.
In addition to active and passive immunoprophylaxis, lamivudine, telbivudine and tenofovir in highly viremic mothers can further decrease MTCT of HBV. Based on direct and indirect evidence, tenofovir appears to be more effective than the two other drugs in the prevention of HBV MTCT.
乙型肝炎是一个严重的全球健康问题。乙型肝炎病毒（HBV）母婴传播（MTCT）是 HBV 感染地方性流行的主要危险因素。口服抗病毒药物被推荐用于高病毒血症的母亲，以降低 HBV 的 MTCT。本网络分析比较了现有治疗方法预防 HBV MTCT 的效果。
检索了 PubMed、Embase、Web of Science、Scopus 和万方数据库中的合格研究。应用两两荟萃分析和贝叶斯网络分析比较抗病毒药物的疗效。
75 项涉及 12740 名孕妇的研究符合分析标准。两两分析显示，拉米夫定（OR 0.15，95%CI 0.09-0.25，I-squared=0%）、替比夫定（OR 0.07，95%CI 0.05-0.10，I-squared=0%）和替诺福韦（OR 0.07，95%CI 0.04-0.13，I-squared=0%）显著降低了 MTCT 率。基于贝叶斯分析的排序概率的多项比较结果显示，替诺福韦（SUCRA=96.83%）比其他两种药物更有效。
除了主动和被动免疫预防外，高病毒血症母亲使用拉米夫定、替比夫定和替诺福韦还可以进一步降低 HBV 的 MTCT。基于直接和间接证据，替诺福韦在预防 HBV MTCT 方面似乎比其他两种药物更有效。
