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替比夫定阻断HBV母婴传播的效果和短期安全性

潘禹辰 王崇 文思敏 王川 孔菲 牛俊奇 姜晶

引用本文:
Citation:

替比夫定阻断HBV母婴传播的效果和短期安全性

DOI: 10.3969/j.issn.1001-5256.2017.09.015
基金项目: 

十二五国家科技重大专项课题子课题(2012ZX10002001-001); 吉林省卫生计生科研计划(20152003); 中国肝炎防治基金会-天晴肝病基金资助课题(TQGB 20140137); 

详细信息
  • 中图分类号: R714.251

Clinical effect and short-term safety of telbivudine in blocking mother-to-child transmission of HBV

Research funding: 

 

  • 摘要: 目的观察高病毒载量乙型肝炎孕妇在孕晚期服用替比夫定对HBV母婴传播的阻断效果和短期安全性。方法募集2012年7月-2015年6月在吉林大学第一医院接受母婴阻断的HBsAg和HBe Ag均阳性,HBV DNA≥2×106IU/ml的孕妇;向孕妇说明目前乙型肝炎母婴传播阻断所采用的方法,根据其意愿分为主被动免疫阻断+替比夫定组(替比夫定组)和主被动免疫阻断组(免疫阻断组)。替比夫定组孕妇从妊娠32周开始,口服替比夫定(600 mg,1次/d)至分娩时停药,免疫阻断组孕妇孕期不接受任何抗病毒治疗;2组婴儿产后均接受20μg乙型肝炎疫苗联合100单位乙型肝炎免疫球蛋白的主被动免疫;7月龄时婴儿检测HBsAg阳性者为母婴传播阻断失败。符合正态分布的计量资料组间比较采用t检验;不符合正态分布的计量资料组间比较采用Wilcoxon秩和检验。计数资料组间比较采用χ2检验或Fisher精确检验。结果符合纳入标准的孕妇447例,其中替比夫定组81例,免疫阻断组366例。替比夫定组孕妇平均年龄高于免疫阻断组[(28.8±3.3)岁vs(27.6±3.8)岁,t=-...

     

  • [1]BEASLEY RP, HWANG LY, LIN CC, et al.Hepatocellular carcinoma and hepatitis B virus.A prospective study of 22 707 men in Taiwan[J].Lancet, 1981, 2 (8256) :1129.
    [2]MA L, ALLA NR, LI X, et al.Mother-to-child transmission of HBV:review of current clinical management and prevention strategies[J].Rev Med Virol, 2014, 24 (6) :396-406.
    [3]ORLANDO R, FOGGIA M, MARAOLO AE.Prevention of hepatitis Bvirus infection:from the past to the future[J].Eur J Clin Microbiol Infect Dis, 2015, 34 (6) :1059-1070.
    [4]ZHOU YH, HU YL.Achievements and challenges in the prevention of mother-to-child transmission of hepatitis B virus in China[J].Natl Med J China, 2015, 95 (1) :15-18. (in Chinese) 周乙华, 胡娅莉.我国预防乙型肝炎病毒母婴传播的成就和挑战[J].中华医学杂志, 2015, 95 (1) :15-18.
    [5]DEL CR, GROSHEIDE PM, MAZEL JA, et al.Ten-year neonatal hepatitis B vaccination program, The Netherlands, 1982-1992:protective efficacy and long-term immunogenicity[J].Vaccine, 1997, 15 (15) :1624-1630.
    [6]CHEN J, JIA JD.Guided reading of 2008 Asian-Pacific consensus statement on the management of chronic hepatitis B[J].Infect Dis Inform, 2008, 21 (4) :193-195. (in Chinese) 陈杰, 贾继东.亚太地区肝病学会2008年《慢性乙型肝炎治疗共识》导读[J].传染病信息, 2008, 21 (4) :193-195.
    [7]CHEN HL, LIN LH, HU FC, et al.Effects of maternal screening and universal immunizationto prevent mother-to-infant transmission of HBV[J].Gastroenterology, 2012, 142 (142) :773-781.
    [8]YANG M, LIU YX.New progress of the influencefactors of mother-tochild transmission of chronic hepatitis B[J/CD].Chin J Liver Dis:Electronic Edition, 2016, 10 (3) :265-268. (in Chinese) 杨敏, 刘映霞.慢性乙型肝炎母婴传播的影响因素新进展[J/CD].中华实验和临床感染病杂志:电子版, 2016, 10 (3) :265-268.
    [9]LIANG X, BI S, YANG W, et al.Epidemiological serosurvey of hepatitis B in China---declining HBV prevalence due to hepatitis B vaccination[J].Vaccine, 2009, 27 (47) :6550-6557.
    [10]LIANG X, BI S, YANG W, et al.Evaluation of the impact of hepatitis B vaccination amon children born during 1992-2005 in China[J].J Infect Dis, 2009, 200 (1) :39-47.
    [11]Chinese Society of Hepatology and Chinese Society of Infectious Diseases, Chinese Medical Association.The guideline of prevention and treatment for chronic hepatitis B:a 2015 update[J].J Clin Hepatol, 2015, 31 (12) :1941-1960. (in Chinese) 中华医学会肝病学分会, 中华医学会感染病学分会.慢性乙型肝炎防治指南 (2015年新版) [J].临床肝胆病杂志, 2015, 31 (12) :1941-1960.
    [12]HALLIDAY ML, KANG LY, RANKIN JG, et al.An efficacy trial of a mammalian cell-derived recombinant DNA hepatitis B vaccine in infants born to mothers positive for HBs Ag, in Shanghai, China[J].Int JEpidemiol, 1992, 21 (3) :564-573.
    [13]STEVENS CE, TOY PT, TAYLOR PE, et al.Prospects for control of hepatitis B virus infection:implications of childhood vaccination and long-term protection[J].Pediatrics, 1992, 90 (12) :170-173.
    [14]ZOU H, CHEN Y, DUAN Z, et al.Virologic factors associated with failure to passive-active immunoprophylaxis in infants born to HBs Ag-positive mothers[J].J Viral Hepat, 2012, 19 (2) :18-25.
    [15]GODBOLE G, IRISH D, BASARAB M, et al.Management of hepatitis B in pregnant women and infants:a multicentre audit from four London hospitals[J].BMC Pregnancy Childbirth, 2013, 13:222.
    [16]WANG C, WANG C, JIA ZF, et al.Protective effect of an improved immunization practice of mother-to-infant transmission of hepatitis Bvirus and risk factors associated with immunoprophylaxis failure[J].Medicine, 2016, 95 (34) :e4390.
    [17]DENG Y, WU WX, ZHANG DZ, et al.The saty of telbivudine in preventing mother-to-infant transmission of hepatitis B virus in pregnant women after discontinuation[J].Chin J Hepatol, 2015, 23 (8) :586-589. (in Chinese) 邓勇, 吴维新, 张大志, 等.替比夫定阻断乙型肝炎病毒母婴传播停药后的安全性研究[J].中华肝脏病杂志, 2015, 23 (8) :586-589.
    [18]ZHANG H, PAN CQ, PANG Q, et al.Telbivudine or lamivudine use in late pregnancy safely reduces perinatal transmission of hepatitis B virus in real-life practice[J].Hepatology, 2014, 60 (2) :468-474.
    [19]HAN GR, JIANG HX, YUE X, et al.Efficacy and safety of telbivudine treatment:an open-label, prospective study in pregnant women for the prevention of perinatal transmission of hepatitis B virus infection[J].J Viral Hepat, 2015, 22 (9) :754-762.
    [20]PAN CQ, HAN GR, JIANG HX, et al.Telbivudine prevents vertical transmission from HBe Ag-positive women with chronic hepatitis B[J].Clin Gastroenterol Hepatol, 2012, 10 (5) :520-526.
    [21]BRIDGES EG, SELDEN JR, LUO S.Nonclinical safety profile of telbivudine, a novel potent antiviral agent for treatment of hepatitis B[J].Antimicrob Agents Chemother, 2008, 52 (7) :2521-2528.
    [22]DIENSTAG J, EASLEY C, KIRKPATRICK P.Telbivudine[J].Nat Rev Drug Discov, 2007, 6 (4) :267-268.
    [23]RUIZ-SANCHO A, SHELDON J, SORIANO V.Telbivudine:a new option for the treatment of chronic hepatitis B[J].Expert Opin Biol Ther, 2007, 7 (5) :751-761.
    [24]PIRATVISUTH T, GUO RH, POL S, et al.Comprehensive review of telbivudine in pregnant women with chronic hepatitis B[J].World J Hepatol, 2016, 8 (9) :452.
    [25]ZHOU YJ, ZHENG JL, PAN HJ, et al.Long-term efficacy and safety of telbivudine in the treatment of childbearing patients with chronic hepatitis B[J].Chin J Hepatol, 2014, 22 (8) :573-576. (in Chinese) 周岳进, 郑金莉, 潘华将, 等.替比夫定治疗妊娠慢性乙型肝炎患者生育子女远期疗效与安全性[J].中华肝脏病杂志, 2014, 22 (8) :573-576.
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  • 收稿日期:  2017-05-12
  • 出版日期:  2017-09-20
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