Abstract：Objective: To compare the effects of tenofovir and tebivudine on serum viral load and liver function of pregnant women in preventing mother-to-child transmission of hepatitis B. Methods: A total of 249 pregnant women with HBsAg and HBeAg double positive and HBV DNA≥1×106IU/mL who were admitted to our hospital from June 2018 to December 2019 were retrospectively analyzed. They were divided into three groups according to whether or not they were taking antiviral drugs and the different types of antiviral drugs: Group A (oral tenofovir, n=123), group B (oral tebivudine, n=85), and group C (no antiviral drugs, n=41). Group A and group B began taking medication in the middle and late trimester of pregnancy and stopped taking medication until delivery. All newborns were injected with hepatitis B immunoglobulin 100IU within 24 hours of birth, and hepatitis B vaccine was administered according to standard immunization procedures. The changes of HBV DNA levels in pregnant women before and after treatment and the effect of mother-to-child transmission blocking were compared, as well as the changes of liver function during pregnancy and postpartum. Results: Before delivery, there were statistically significant differences in the overall distribution of HBV DNA in groups A, B and C(H =109.006,P<0.001). Before delivery, 98.4% and 97.7% of pregnant women in group A and B had HBV DNA levels below 1×106IU/mL, respectively. There was no significant difference in the distribution of serum HBV DNA levels between group A and B (P>0.05). Before delivery, serum ALT and AST levels of pregnant women in groups A and B were significantly lower than those before treatment, and lower than those in group C (P<0.05). There was no significant difference in the incidence of abnormal liver function among all groups after delivery (χ2=0.215, P>0.05), and there was no significant difference in the overall distribution of serum ALT levels among the three groups (P>0.05). The success rate of mother-to-child transmission blocking was 100% in group A and B, and 97.6% in group C. Conclusion: Both tenofovir and tebivudine can effectively reduce viral load of hepatitis B, and there is no difference in reducing viral load and improving liver function during pregnancy. The use of antiviral drugs does not increase the risk of hepatitis flare after postpartum withdrawal, but it is necessary to pay close attention to the changes of postpartum liver function regardless of whether antiviral drugs are used.
陈志英, 李妍, 谷金玉, 杨超. 不同核苷(酸)类似物对HBV感染孕妇病毒载量和肝功能的影响分析[J]. 河北医学, 2022, 28(6): 997-1001.
CHEN Zhiying, LI Yan, GU Jinyu, et al. Analysis of the Effects of Different Nucleoside (Acid) Analogues on Viral Load and Liver Function in HBV-Infected Pregnant Women. HeBei Med, 2022, 28(6): 997-1001.
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2022, Vol. 28 
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