Efficancy and safty of antiviral treatment for chronic hepatitis B patients in second trimester of pregnancy / 中华临床感染病杂志

ABSTRACT

Objective To evaluate the efficacy and safty of antiviral treatment for chronic hepatitis B ( CHB ) patients in second trimester of pregnancy.Methods Seventy-nine CHB patients in second trimester of pregnancy were collected from Hangzhou First People’ s Hospital and Xixi Hospital of Hangzhou during January 2010 to December 2013.Patients were divided into antiviral treatment group ( n=47) and the control group (n=32) according to their own wishes.Patients in antiviral treatment group were given lamivudine or telbivudine treatment plus hepatoprotective medication, while those in control group were only given hepatoprotective medication.All pregnant women were observed for 12 weeks after childbirth and the neonates were followed-up for 6 months after birth.The liver function, HBV DNA loads, HBV serological markers were measured;adverse effects during pregnancy, blocking rates of mother-to-child transmission and the growth of neonates were documented.t test or Chi-square test was used for statistical analysis.Results Alanine aminotransferase ( ALT) normalization rate and HBV DNA negative rate in antiviral treatment group before childbirth were 88.6%(39/44) and 84.1%(37/44) , while those in the control group were 60.0%(18/30) and 0 (χ2 =8.27 and 50.46, P0.05).No patient in antiviral treatment group terminated pregnancy due to abnormal liver function or adverse effect of drugs, while 2 out of 30 patients (6.7%) in the control group terminated the pregnancy, but the difference between two groups was not of statistical significance (χ2 =1.01, P >0.05).Mother-to-child transmission of HBV was successfully blocked in antiviral treatment group, while 3 cases (11.5%) in control group were failed (χ2 =5.19, P0.05).Conclusion Antiviral treatment can improve liver function, inhibit HBV replication and reduce the risk of mother-to-child transmission, and is safe for CHB patients in second trimester of pregnancy.