|
|
|
| Analysis of the Effects of Different Nucleoside (Acid) Analogues on Viral Load and Liver Function in HBV-Infected Pregnant Women |
| CHEN Zhiying, LI Yan, GU Jinyu, et al |
| Shijiazhuang Maternal and Child Health Care Hospital, Hebei Shijiazhuang 050000, China |
|
|
|
|
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.
|
|
|
|
|
|
[1] Kang W,Li Q,Shen L,et al.Risk factors related to the failure of prevention of hepatitis B virus mother-to-child transmission in Yunnan,China[J].Vaccine,2017,35(4):605-609.
[2] 崔富强,庄辉.我国新生儿乙型肝炎母婴阻断成就和展望[J].中国病毒病杂志,2019,9(5):321-326.
[3] 曹香芸,管艳萍,李倩,等.替诺福韦、替比夫定分别联合双重免疫方案对HBV母婴传播阻断效果的比较[J].肝脏,2019,24(5):503-506.
[4] Sheng QJ,Ding Y,Li BJ,et al.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[J].Int Med Sci,2018,15(8):796-801.
[5] 黄永群,黄润强,熊平安.替诺福韦酯联合双重免疫方案阻断HBV携带孕妇母婴病毒传播效果研究[J].实用肝脏病杂志,2021,24(3):331-334.
[6] Zeng J,Zheng C,Li H.Effectiveness of tenofovir or telbivudine in preventing HBV vertical transmission for pregnancy[J].Medicine,2019,98(14):15092.
[7] 丁洋,盛秋菊,张翀,等.慢性乙型肝炎病毒感染孕妇妊娠期肝炎发作的临床特点及抗病毒治疗的疗效[J].中华肝脏病杂志,2019,27(2):106-111.
[8] Liu J,Wang J,Jin D,et al.Hepatic flare after telbivudine withdrawal and efficacy of postpartum antiviral therapy for pregnancies with chronic hepatitis B virus[J].Gastroenterol Hepatol,2017,32(1):177-183.
[9] 尹迎辉,董明亮,石梅,等.慢性乙型肝炎病毒感染孕妇抗病毒停药时间对产后肝功能及母婴传播的影响[J].中国感染与化疗杂志,2018,18(3):263-266 |
|
|
|
2022, Vol. 28 
