Decreased neonatal hepatitis B virus (HBV) viremia by maternal tenofovir treatment predicts reduced chronic HBV infection in children born to highly viremic mothers

被引：27

作者：

Chang, Kai-Chi ^{[3
,4
,5
]}

Chang, Mei-Hwei ^{[6
,7
]}

Lee, Chien-Nan ^{[8
]}

Chang, Chin-Hao ^{[9
]}

Wu, Jia-Feng ^{[10
]}

Ni, Yen-Hsuan ^{[7
,10
]}

Wen, Wan-Hsin ^{[2
,11
]}

Shyu, Ming-Kwang ^{[8
]}

Lai, Ming-Wei ^{[12
,13
,14
]}

Chen, Shih-Ming ^{[15
]}

Hu, Jen-Jan ^{[16
]}

Lin, Hans Hsienhong ^{[17
]}

Hsu, Jenn-Jeih ^{[18
]}

Mu, Shu-Chi ^{[19
]}

Lin, Yu-Cheng ^{[20
]}

Liu, Chun-Jen ^{[21
]}

Chen, Ding-Shinn ^{[21
]}

Lin, Lung-Huang ^{[1
,2
,10
]}

Chen, Huey-Ling ^{[1
,2
,7
,10
]}

Hwa, Hsiao-Lin ^{[22
]}

Su, Yi-Ning ^{[22
]}

Shih, Jin-Chung ^{[22
]}

Chao, Kuang-Han ^{[22
]}

Hsu, Hong-Yuan ^{[22
]}

Chiu, Yu-Chun ^{[23
]}

Su, Tung-Hung ^{[24
]}

Lin, Chin-Chuan ^{[15
,25
]}

Lin, Pei-Ying ^{[15
,25
]}

Yang, Wen-Rong ^{[15
,25
]}

Zhao, Lu-Lu ^{[26
]}

Yang, Chun-Kuang ^{[27
]}

Chang, Yin-Kuang ^{[27
]}

Chen, Kuo-Hu ^{[27
]}

Lin, Yu-Hung ^{[28
]}

Chen, Heng-Ju ^{[28
]}

Pan, Hun-Shan ^{[28
]}

Lau, Beng-Huat ^{[19
,29
]}

Wu, Shin Kong ^{[19
]}

Lee, Chyi-Long ^{[30
]}

Cheng, Po-Jen ^{[30
]}

Chang, Yao-Lung ^{[30
]}

Chiueh, Ho-Yen ^{[30
]}

Wang, Tzu-Hao ^{[30
]}

Lo, Liang-Ming ^{[31
]}

Hsieh, Chia-Lin ^{[31
]}

Cheng, Shao-Wen ^{[32
]}

Tsai, Ming-Song ^{[33
]}

She, Bo-Qing ^{[34
]}

Koh, King-Jun ^{[35
]}

Hung, Yi-Li ^{[35
]}

机构：

[1] Cathay Gen Hosp, Dept Pediat, 280,Sec 4,Renai Rd, Taipei 106, Taiwan

[2] Fu Jen Catholic Univ, Sch Med, 510 Zhongzheng Rd, New Taipei 242, Taiwan

[3] Natl Taiwan Univ, Coll Med, Grad Inst Clin Med, Taipei, Taiwan

[4] Natl Taiwan Univ Coll Med & Hosp, Dept Pediat, Taipei, Taiwan

[5] Natl Taiwan Univ Coll Med & Hosp, Dept Emergency, Taipei, Taiwan

[6] Natl Taiwan Univ Coll Med & Hosp, Dept Pediat, Taipei, Taiwan

[7] Natl Taiwan Univ Coll Med & Hosp, Hepatitis Res Ctr, Taipei, Taiwan

[8] Natl Taiwan Univ Coll Med & Hosp, Obstet & Gynecol, Taipei, Taiwan

[9] Natl Taiwan Univ Coll Med & Hosp, Med Res, Taipei, Taiwan

[10] Natl Taiwan Univ Coll Med & Hosp, Dept Pediat, Taipei, Taiwan

[11] Cardinal Tien Hosp, Dept Pediat, New Taipei, Taiwan

[12] Chang Gung Univ, Coll Med, Dept Pediat, Div Pediat Gastroenterol, Taoyuan, Taiwan

[13] Chang Gung Univ, Coll Med, Liver Res Ctr, Taoyuan, Taiwan

[14] Chang Gung Mem Hosp, Taoyuan, Taiwan

[15] Taiwan Adventist Hosp, Dept Obstet & Gynecol, Taipei, Taiwan

[16] Taiwan Adventist Hosp, Dept Pediat, Taipei, Taiwan

[17] Buddhist Tzu Chi Gen Hosp, Dept Internal Med, Taipei, Taiwan

[18] Taipei Chang Gung Mem Hosp, Dept Obstet & Gynecol, Taipei, Taiwan

[19] Shin Kong Wu Ho Mem Hosp, Dept Pediat, Taipei, Taiwan

[20] Far Eastern Mem Hosp, Dept Pediat, New Taipei, Taiwan

[21] Natl Taiwan Univ Coll Med & Hosp, Internal Med & Hepatitis Res Ctr, Taipei, Taiwan

[22] Natl Taiwan Univ Hosp, Dept Obstet & Gynecol, Taipei, Taiwan

[23] Natl Taiwan Univ Hosp, Dept Pediat, Taipei, Taiwan

[24] Natl Taiwan Univ Hosp, Dept Internal Med, Taipei, Taiwan

[25] Taiwan Adventist Hosp, Dept Obstet Gynecol, Taipei, Taiwan

[26] Taipei Tzu Chi Hosp, Dept Pediat, Taipei, Taiwan

[27] Taipei Tzu Chi Hosp, Dept Obstet & Gynecol, Taipei, Taiwan

[28] Shin Kong Wu Ho Su Mem Hosp, Dept Obstet & Gynecol, Taipei, Taiwan

[29] Shin Kong Wu Ho Su Mem Hosp, Dept Pediat, Taipei, Taiwan

[30] Chang Gung Mem Hosp, Dept Obstet & Gynecol, Linkou, Taiwan

[31] Chang Gung Mem Hosp, Dept Obstet & Gynecol, Taipei, Taiwan

[32] Chang Gung Mem Hosp, Dept Pediat, Taipei, Taiwan

[33] Cathay Gen Hosp, Dept Obstet & Gynecol, Taipei, Taiwan

[34] Sijhih Cathay Gen Hosp, Dept Obstet & Gynecol, New Taipei, Taiwan

[35] Sijhih Cathay Gen Hosp, Dept Pediat, New Taipei, Taiwan

[36] Far Eastern Mem Hosp, Dept Obstet & Gynecol, New Taipei, Taiwan

[37] Taipei Vet Gen Hosp, Dept Pediat, Taipei, Taiwan

[38] Taipei Vet Gen Hosp, Dept Obstet & Gynecol, Taipei, Taiwan

[39] MacKay Mem Hosp, Dept Obstet, Taipei, Taiwan

[40] MacKay Mem Hosp, Dept Pediat, Taipei, Taiwan

[41] MacKay Mem Hosp, Dept Obstet & Gynecol, Mackay, Taiwan

[42] En Chu Kong Hosp, Dept Obstet & Gynecol, New Taipei, Taiwan

[43] En Chu Kong Hosp, Dept Pediat, New Taipei, Taiwan

[44] Triserv Gen Hosp, Dept Obstet & Gynecol, Taipei, Taiwan

[45] Triserv Gen Hosp, Dept Pediat, Taipei, Taiwan

来源：

ALIMENTARY PHARMACOLOGY & THERAPEUTICS | 2019年 / 50卷 / 03期

关键词：

TO-INFANT TRANSMISSION; PREVENT PERINATAL TRANSMISSION; VERTICAL TRANSMISSION; IMMUNOPROPHYLAXIS FAILURE; HEPATOCELLULAR-CARCINOMA; DISOPROXIL FUMARATE; RISK-FACTORS; PREGNANCY; EFFICACY; IDENTIFICATION;

D O I：

10.1111/apt.15321

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background Maternal anti-viral treatment prevents mother-to-infant transmission of hepatitis B virus (HBV), but the role of neonatal viremia on subsequent HBV infection is not clear. Aims To investigate the effect of maternal anti-viral treatment on neonatal serum HBV DNA and hepatitis B surface antigen (HBsAg) in infants born to highly viremic mothers and the roles of neonatal markers in predicting chronic HBV infection in children. Methods Serum HBV DNA and HBsAg were tested in children. Of the 201 pregnant mothers, 110 received tenofovir during the third trimester. Chronic infection in children was defined by HBsAg seropositivity at 6 or 12 months lasting more than 6 months. Results The maternal HBV viral loads from baseline to delivery were 8.25 +/- 0.48 to 4.29 +/- 0.98 log(10) IU/mL; and 8.29 +/- 0.49 to 8.12 +/- 0.68 log(10) IU/mL in the tenofovir and control group respectively. Of the 208 children, those in the tenofovir group had a lower rate of neonatal HBV DNA seropositivity at birth (5.22% vs 30.11%, P < 0.0001) and HBsAg seropositivity at 6 months (1.74% vs 11.83%, P = 0.003) and 12 months (1.74% vs 10.75%, P = 0.007). In a first multivariate analysis, maternal HBV DNA level at delivery (odds ratio = 1.70, P = 0.0172) and neonatal HBsAg positivity (odds ratio = 19.37, P < 0.0001) were significantly associated with children's chronic HBV infection. In a second model, neonatal HBV DNA positivity was a strong independent influence variable (odds ratio = 61.89, P = 0.0002). Conclusions Maternal tenofovir therapy decreased maternal viral load and neonatal viremia. Positive neonatal HBV DNA was highly correlated with chronic HBV infection in children. Clinical Trial Identifier: NCT01312012.

引用

页码：306 / 316

页数：11

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