Efficacy of combination antiviral therapy following childbirth in pregnant HBV carriers receiving telbivudine for prevention of mother-to-child transmission.
- Author:
Jun-Feng LU
1
;
Ya-Li LIU
;
Li-Na MA
;
Zhen-Huan CAO
;
Zhi-Min HE
;
Yi JIN
;
Shi-Bin ZHANG
;
Xin-Yue CHEN
Author Information
- Publication Type:Journal Article
- MeSH: Adenine; analogs & derivatives; therapeutic use; Alanine Transaminase; blood; Antiviral Agents; therapeutic use; Carrier State; virology; DNA, Viral; blood; Drug Therapy, Combination; Female; Hepatitis B Surface Antigens; blood; Hepatitis B e Antigens; blood; Hepatitis B, Chronic; drug therapy; Humans; Infectious Disease Transmission, Vertical; prevention & control; Interferon-alpha; therapeutic use; Organophosphonates; therapeutic use; Polyethylene Glycols; therapeutic use; Pregnancy; Pregnancy Complications, Infectious; drug therapy; virology; Pregnancy Trimester, Third; Recombinant Proteins; therapeutic use; Thymidine; analogs & derivatives; therapeutic use
- From: Chinese Journal of Hepatology 2015;23(11):821-825
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVETo observe the clinical efficacy of combination therapy with peg-IFNalpha and adefovir (CPIA) in women who were hepatfis B virus (HBV) carriers and had just given birth and received telbivudine (LdT) during pregnancy for prevention of mother-to-child transmission.
METHODSOne-hundred-and-fifty third trimester-pregnant women who were HBV carriers with highly-viremic were treated with LdT until time of birth. After delivery, those women with alanine aminotransferase (ALT) level exceeding two times the upper limit of normal and HBV DNA level that had decreased more than 31 gIU/mL or hepatitis B e antigen (HBeAg) titer that had decreased more than 50% were switched to CPIA for 96 weeks.
RESULTSFollowing delivery, 45 of the women were switched to the CPIA treatment, of which 91.1% (41/45) achieved virological response, 55.6% (25/45) achieved HBeAg clearance or seroconversion, and 26.7% (12/45) achieved hepatitis B surface antigen (HBsAg) clearance or seroconversion.The immediate post-delivery (and pre-CPIA) levels of HBeAg and HBV DNA were negatively associated with HBeAg clearance. Ninety-eight of the total study participants stopped the LdT treatment and there were no cases of significant deterioration of liver function.
CONCLUSIONPregnant women who are HBV carriers and receive LdT for protection against mother-to-child transmission, and who show significant ALT elevation and decreased HBeAg titer and/or reduced HBV DNA after delivery, may be good candidates for the CPIA therapy following delivery.
