ABSTRACT
Objective To analyze and compare the HBV DNA contents in serum and breast milk after injection of hepatitis B im‐munoglobulin (HBIG) in different periods of pregnant and lying‐in women to provide the experimental basis for blocking the mater‐nal‐neonatal transmission(PMTCT) and breast feeding scheme .Methods 140 pregnant women carrying hepatitis B virus with HB‐sAg(+ ) by antenatal examination in the obstetric outpatient department of our hospital from June 2012 to June 2014 were selected and divided into the research group and the control group according to the voluntary and secretive principle .Among them ,75 cases in the research group were intramuscularly injected by high titer HBIG 200 U at 28 ,32 ,36 weeks of pregnancy ,while 65 cases in the control group were injected by HBIG at the end of pregnancy due to different causes .Serum HBV‐DNA content before injection and before delivery was detected in the two groups ,and which in neonatal serum and breast milk within 3-5 d also detected .The differences and correlation between the two groups were analyzed .Results The HBV‐DNA content 1 × 106 copies/mL before HBIG injection in the research group were 28 cases ,17 cases ,30 cases respectively ,which before delivery were 35 cases ,20 cases ,20 cases respectively ;which in antenatal twice detection in the control group were 19 cases , 21 cases ,25 cases and 20 cases ,17 cases ,28 cases respectively ;neonatal serum HBV‐DNA positive in the research group and control group had 1 case(5 .3% ) and 5 cases (7 .7% ) respectively ;the breast milk HBV‐DNA positive in the two groups had 3 cases(4% )/and 8 cases(12 .3% ) respectively .Conclusion HBIG injection at late pregnancy in the pregnant women carrying HBV could influ‐ence the HBV replication ,thus reduces the probability of neonatal intrauterine infection ,at the same time reduces the HBV‐DNA positive rate of postpartum breast milk .
ABSTRACT
Objective To compare the efficacy of lamivudine and telbivudine combined with hepatitis B vaccine in blocking vertical transmission of hepatitis B virus (HBV) in pregnant women with HBV infection during late stage of pregnancy.Methods From January 2010 to December 2013,195 pregnant women with HBV infection who received prenatal examination and institutional delivery were enrolled and randomized into three groups based on random number table method,lamivudine group,telbivudine group and control group,65 cases in each group.The subjects in lamivudine group and telbivudine group orally took lamivudine 100 mg/d and telbivudine 600 mg/d respectively,from the 28th week of gestation to 1 month after delivery.The primary end point was HBsAg positivity of infants at 12 months of age.Results Serum lgHBV DNA level of mothers in lamivudine group was 3.7 ± 1.2,and in telbivudine group was 3.6 ± 1.5,in control group was 8.4 ± 1.7.The serum lgHBV DNA level of mothers in lamivudine group and telbivudine group was significantly lower than that in control group (P ＜ 0.01).HBsAg positivity rate of infants at 12 months of age in lamivudine group was 3.1％(2/65),in telbivudine group was 4.6％(3/65),and in control group was 15.4％ (10/65).HBsAg positivity rate of infants at 12 months of age in lamivudine group and telbivudine group was significantly lower than that in control group (P ＜ 0.05).Conclusion Lamivudine and telbivudine are both effective in preventing vertical transmission of HBV for pregnant women with HBV infection in late stage of pregnancy,and further clinical study is required.