Characteristics and predictors of ALT flare in postpartum women with tenofovir blocking mother-to-child transmission of HBV after drug discontinuation
10.3760/cma.j.cn112866-20211009-00181
- VernacularTitle:替诺福韦酯阻断HBV母婴传播停药后产妇ALT复发的特征及预测因素
- Author:
Liuqing YANG
1
;
Ling QING
;
Yanjie LI
;
Li ZHANG
;
Yingxia LIU
Author Information
1. 深圳市第三人民医院感染三科，深圳 518112
- Keywords:
Tenofovir disoproxil fumarate;
Blocking mother-to-child transmission of HBV;
Alanine transaminase flare
- From:
Chinese Journal of Experimental and Clinical Virology
2022;36(3):300-305
- CountryChina
- Language:Chinese
-
Abstract:
Object:To observe the characteristics and predictors of alanine aminotransferase (ALT) flare in postpartum women with chronic HBV infection and high viral load who were prevented from mother-to-child transmission of HBV by anti-HBV intervention during pregnancy.Methods:Data of pregnant women seen at the Third People’s Hospital of Shenzhen liver disease outpatient clinic who met inclusion and exclusion criteria of chronic hepatitis B virus (HBV) infection were collected, including data recorded before and after antiviral therapy during pregnancy, postpartum regular 4 to 6 weeks, 12, 36, 48, 72, and 96 weeks of follow-up, results of liver function tests, HBV serological markers and HBV DNA quantitative examinations. The characteristics of normal and abnormal postnatal ALT groups were compared, and the risk factors of abnormal postnatal ALT were analyzed by logistic regression.Results:A total of 100 women with chronic HBV infection were enrolled from September 1, 2018 to December 31, 2020. All 94 women with chronic HBV infection experienced virological recurrence within 12 weeks after delivery and continued to be HBeAg positive. The rate of ALT flare (>ULN) was 60%, most of which occurred within 12-24 weeks after delivery, and most of which returned to normal without special treatment. However, ALT flare still occurred in 27% of cases within 48-96 weeks after delivery. A total of 24 patients with postnatal ALT≥5×ULN were treated with antiviral therapy again. Logistic multifactor regression analysis suggested that elevation of ALT (>ULN) after delivery and drug discontinuation was associated with ALT elevation occurred during delivery, the odds ratio (OR) was 1.089.Conclusions:ALT flare in postpartum women is common, and most of them can return to normal without special treatment. However, ALT flare still occurs after 48 weeks of delivery, and antiviral therapy is needed again. Therefore, long-term follow-up should be standardized for pregnant women with high viral load and chronic HBV infection after delivery.
