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评估替诺福韦酯处方时的慢性乙型肝炎病毒感染孕妇:越南一项前瞻性队列研究的基线特征

Pregnant women with chronic hepatitis B virus infection at the assessment of tenofovir disoproxil fumarate prescription: Baseline characteristics of a prospective cohort study in Vietnam.

作者信息

Pham Tran Dieu Hien, Le Manh Hung, Pham Quang Duy, Phung Khanh Lam, Nguyen Minh Ngoc, Ha Thi Bich Ngoc, Dao Bach Khoa, Le Thanh Phuong, Nguyen Thanh Dung, Hoang Quoc Cuong

机构信息

Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam.

Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam.

出版信息

IJID Reg. 2024 May 7;11:100375. doi: 10.1016/j.ijregi.2024.100375. eCollection 2024 Jun.

Abstract

OBJECTIVES

We aimed to determine epidemiological characteristics and serologic markers among chronically hepatitis B virus (HBV)-infected pregnant women during the assessment of tenofovir disoproxil fumarate (TDF) prescription in Vietnam.

METHODS

We consecutively recruited 375 pregnant women with chronic HBV (cHBV) infection at week 25±2 of pregnancy, at which time they were assessed for TDF use as pre-prophylaxis and/or pre-treatment at the Hospital for Tropical Diseases in southern Vietnam during December 2019-April 2021. Demographic characteristics, serological biomarkers, and prenatal liver ultrasounds were obtained through interviews and reviews of medical records.

RESULTS

The median age of pregnant women was 29 years (interquartile range: 26-32). More than half of pregnant women (208/375; 55.5%) started TDF for prevention of mother-to-child transmission of HBV and/or treatment of chronic hepatitis B (CHB). Among the pregnant women initiating TDF, 96.1% (198/206) tested positive for hepatitis B e antigen, and 21.6% (45/208) had quantitative hepatitis B surface antigen (qHBsAg) ≤10 IU/mL. A relatively strong correlation between qHBsAg and HBV deoxyribonucleic acid (DNA) ( = 0.81; 95% CI: 0.76-0.85) was observed in pregnant women starting TDF.

CONCLUSIONS

Our results demonstrate the high need for TDF prescription for prevention and/or treatment purposes in pregnant women with cHBV infection. Pregnant women with qHBsAg levels ≤10 IU/mL may prioritize HBV DNA testing over qHBsAg to decide on TDF prescription.

摘要

目的

在越南评估替诺福韦酯(TDF)处方期间,我们旨在确定慢性乙型肝炎病毒(HBV)感染孕妇的流行病学特征和血清学标志物。

方法

我们在妊娠第25±2周连续招募了375例慢性HBV(cHBV)感染孕妇,于2019年12月至2021年4月期间在越南南部热带病医院对她们进行TDF用作预防和/或预处理的评估。通过访谈和查阅病历获取人口统计学特征、血清生物标志物和产前肝脏超声检查结果。

结果

孕妇的中位年龄为29岁(四分位间距:26 - 32岁)。超过一半的孕妇(208/375;55.5%)开始使用TDF预防HBV母婴传播和/或治疗慢性乙型肝炎(CHB)。在开始使用TDF的孕妇中,96.1%(198/206)乙肝e抗原检测呈阳性,21.6%(45/208)的乙肝表面抗原定量(qHBsAg)≤10 IU/mL。在开始使用TDF的孕妇中观察到qHBsAg与HBV脱氧核糖核酸(DNA)之间存在相对较强的相关性(r = 0.81;95%CI:0.76 - 0.85)。

结论

我们的结果表明,cHBV感染孕妇对TDF用于预防和/或治疗目的的处方有很高需求。qHBsAg水平≤10 IU/mL的孕妇在决定TDF处方时,可优先进行HBV DNA检测而非qHBsAg检测。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36f6/11140187/995a5484e858/gr1.jpg

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