viernes, 28 de julio de 2017

Telbivudine treatment started in early and middle pregnancy completely blocks HBV vertical transmission | BMC Gastroenterology | Full Text

Telbivudine treatment started in early and middle pregnancy completely blocks HBV vertical transmission | BMC Gastroenterology | Full Text

Biomed Central

BMC Gastroenterology



Telbivudine treatment started in early and middle pregnancy completely blocks HBV vertical transmission

BMC GastroenterologyBMC series – open, inclusive and trusted201717:51
Received: 30 August 2016
Accepted: 3 April 2017
Published: 13 April 2017

Abstract

Background

To evaluate the efficacy and safety of treating HBV-positive mothers with telbivudine in early and middle pregnancy to prevent mother-to-infant HBV transmission.

Methods

The subject population comprised pregnant women with chronic hepatitis B (CHB; n = 188) from January 2013 to June 2015, with HBV DNA ≥1.0 × 107copies/mL and increased alanine aminotransferase levels. Groups A (n = 62) and B (n = 61) were treated with telbivudine starting at 12 weeks or 20–28 weeks after gestation, respectively. Telbivudine was discontinued at postpartum 12 weeks. Group C (n = 65) received no antiviral. All infants were vaccinated with hepatitis B immunoglobulin (200 IU) and HBV vaccine (20 with hepatitis B The maternal HBV DNA levels of the groups were compared. Mother-to-infant transmission of HBV was indicated by the presence of HBsAg in infants 7 months after birth.

Results

Before treatment, the HBV DNA levels of the 3 groups were similar. Before delivery and 12 weeks after delivery, the HBV DNA levels of groups A and B were similar, but both were significantly lower than that of group C (P < 0.01, all). No infants in groups A and B were HBsAg-positive, but the infection rate of group C was 18.4% (P < 0.01). The HBV infection rate of infants was positively associated with the HBV DNA levels of the pregnant mothers.

Conclusion

Administration of telbivudine to HBV-infected mothers, started during early and middle pregnancy, completely blocked mother-to-infant HBV transmission.

Trial registration

The study was registered retrospectively on Janurary 25 in 2016 at Chinese Clinical Trial Registry (ChiCTR-OPC-16007899).

Keywords

Telbivudine Hepatitis B virus Mother-to-infant transmission Fetus safety Drug efficacy

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