Early Start Of Tenofovir Treatment Achieves Better Viral Suppression In Pregnant Women With A High HBV Viral Load: A Real-World Prospective Study

被引:10
作者
Gao, Fan [1 ]
Zhang, Wen-Tao [2 ]
Lin, Ya-Yun [2 ]
Wang, Wei-Min [2 ]
Xu, Na [2 ]
Bai, Gui-Qin [2 ]
机构
[1] Xi An Jiao Tong Univ, Clin Res Ctr, Affiliated Hosp 1, Xian 710061, Shaanxi, Peoples R China
[2] Xi An Jiao Tong Univ, Dept Gynecol & Obstet, Affiliated Hosp 1, 277 Yanta West Rd, Xian 710061, Shaanxi, Peoples R China
来源
INFECTION AND DRUG RESISTANCE | 2019年 / 12卷
关键词
tenofovir disoproxil fumarate; efficacy; safety; second trimester; third trimester; HEPATITIS-B-VIRUS; PRACTICE GUIDELINES MANAGEMENT; DISOPROXIL FUMARATE; PERINATAL TRANSMISSION; ANTIVIRAL THERAPY; EFFICACY; PREVENTION; MOTHERS; SAFETY;
D O I
10.2147/IDR.S228982
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Purpose: To investigate whether tenofovir disoproxil fumarate (TDF) treatment that started from the second trimester had an advantage over TDF treatment that started from the third trimester. Patients and methods: Twenty 35-year-old pregnant women with hepatitis B virus (HBV) DNA >2x106 IU/mL were prospectively enrolled in this study. All participants were divided into two subgroups: the second trimester group who started TDF treatment at 24-27 weeks and the third trimester group who started TDF treatment at 28-30 weeks. The primary outcome was the change in serum HBV DNA level from baseline to delivery. Each parameter was tested every 4 weeks from TDF initiation to 3 months postpartum. Results: There were 80 pregnant women in the second trimester group and 49 pregnant women in the third trimester group. The decline in HBV DNA from baseline to delivery was more obvious in the second trimester group (4.8 +/- 1.2 log10 IU/mL) than that in the third trimester group (4.3 +/- 1.1 log10 IU/mL, p=0.041). The downward shift of haemoglobin (HB) from baseline to delivery was greater in the second trimester group (10.6 +/- 10.7 g/L) than in the third trimester group (6.3 +/- 12.3 g/L, p=0.041). The decline in HBV DNA from baseline to delivery was linearly related to the start of TDF treatment from the second trimester (beta=0.50 and 95% CI: 0.26-0.75, p<0.001). There were no significant differences between the two groups regarding HBV serologic markers and safety indicators. Conclusion: Starting TDF treatment from the second trimester achieved better viral suppression than starting TDF treatment from the third trimester in highly viraemic pregnant women without increasing additional adverse reactions. HB level needed frequent monitoring during treatment to avoid anaemia.
引用
收藏
页码:3475 / 3484
页数:10
相关论文
共 29 条
  • [1] [Anonymous], 2015, GUIDELINES PREVENTIO
  • [2] BEASLEY RP, 1988, CANCER, V61, P1942, DOI 10.1002/1097-0142(19880515)61:10<1942::AID-CNCR2820611003>3.0.CO
  • [3] 2-J
  • [4] Antiviral therapy in chronic hepatitis B viral infection during pregnancy: A systematic review and meta-analysis
    Brown, Robert S., Jr.
    McMahon, Brian J.
    Lok, Anna S. F.
    Wong, John B.
    Ahmed, Ahmed T.
    Mouchli, Mohamed A.
    Wang, Zhen
    Prokop, Larry J.
    Murad, Mohammad Hassan
    Mohammed, Khaled
    [J]. HEPATOLOGY, 2016, 63 (01) : 319 - 333
  • [5] Efficacy of maternal tenofovir disoproxil fumarate in interrupting mother-to-infant transmission of hepatitis B virus
    Chen, Huey-Ling
    Lee, Chien-Nan
    Chang, Chin-Hao
    Ni, Yen-Hsuan
    Shyu, Ming-Kwang
    Chen, Shih-Ming
    Hu, Jen-Jan
    Lin, Hans Hsienhong
    Zhao, Lu-Lu
    Mu, Shu-Chi
    Lai, Ming-Wei
    Lee, Chyi-Long
    Lin, Hsien-Ming
    Tsai, Ming-Song
    Hsu, Jenn-Jeih
    Chen, Ding-Shinn
    Chan, K. Arnold
    Chang, Mei-Hwei
    [J]. HEPATOLOGY, 2015, 62 (02) : 375 - 386
  • [6] Cressey TR, 2018, ANTIMICROB AGENTS CH, V62, DOI [10.1128/AAC.01686-18, 10.1128/aac.01686-18]
  • [7] Considerations of antiviral treatment to interrupt mother-to-child transmission of hepatitis B virus in China
    Cui, Fuqiang
    Woodring, Joseph
    Chan, Polin
    Xu, Fujie
    [J]. INTERNATIONAL JOURNAL OF EPIDEMIOLOGY, 2018, 47 (05) : 1529 - 1537
  • [8] Hepatitis B in pregnancy screening, treatment, and prevention of vertical transmission
    Dionne-Odom, Jodie
    Tita, Alan T. N.
    Silverman, Neil S.
    [J]. AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 2016, 214 (01) : 6 - 14
  • [9] Fan R, 2016, NEW ENGL J MED, V375, P1496, DOI 10.1056/NEJMc1609991
  • [10] Efficacy and safety of tenofovir disoproxil fumarate in pregnancy to prevent perinatal transmission of hepatitis B virus
    Greenup, Astrid-Jane
    Tan, Pok Kern
    Nguyen, Vi
    Glass, Anne
    Davison, Scott
    Chatterjee, Ushmi
    Holdaway, Susan
    Samarasinghe, Dev
    Jackson, Kathy
    Locarnini, Stephen A.
    Levy, Miriam T.
    [J]. JOURNAL OF HEPATOLOGY, 2014, 61 (03) : 502 - 507