Effect of withdrawal time on postpartum liver function in pregnant women receiving tenofovir disoproxil fumarate therapy for blocking mother to child transmission of hepatitis B
10.3760/cma.j.issn.1674-2397.2021.05.002
- VernacularTitle:应用富马酸替诺福韦酯阻断乙型肝炎母婴传播不同停药时间对产后肝功能的影响
- Author:
Siying LI
1
;
Yangfang SUN
;
Jinfeng SHI
;
Yi JIANG
;
Xiaoxian JIANG
;
Jie JIN
Author Information
1. 浙江大学医学院附属杭州市第一人民医院感染科 310000
- Keywords:
Hepatitis B;
Mother-infant blockade;
TDF;
Liver function
- From:
Chinese Journal of Clinical Infectious Diseases
2021;14(5):344-350
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effect of withdrawal time on postpartum liver function in pregnant women receiving tenofovir disoproxil fumarate (TDF) therapy for blocking mother-to-child transmission of HBV.Methods:A prospective study was conducted in Hangzhou First People’s Hospital from June 2016 to August 2018. A total of 84 pregnant women with HBsAg and HBeAg positive were enrolled and divided into two groups according to simple randomized grouping method with 42 cases in each group. In group A TDF was withdrawn immediately after delivery and in group B TDF was withdrawn 12 weeks after delivery. Finally, 66 patients completed the follow-up for 24 weeks postpartum, 35 cases in group A and 31 cases in group B. All patients were administered TDF from week 24-28 of pregnancy. HBV DNA loads and ALT levels were regularly measured and compared. Multivariate logistic regression was used to explore the risk factors of postpartum ALT flare. SPSS 26.0 statistical software was used for statistical processing.Results:Compared with the baseline levels, the HBV DNA loads at 16 weeks postpartum had no significant changes in both groups( Z=-0.742 and -1.891, both P>0.05). Postpartum ALT flare was observed in 21 of the 66 patients, 9 cases (25.71%, 9/35) in group A, and 12 cases (38.71%, 12/31) in group B ( χ2=1.280, P>0.05); and there was no significant difference in the severity of postpartum ALT flare between the two groups ( χ2=0.527, P>0.05). Binary logistic regression analysis showed that increased ALT level during pregnancy was an independent risk factor of postpartum ALT flare ( OR=13.75, 95% CI 1.49-126.85, P<0.05). Conclusions:When TDF was used for preventing mother-to-child HBV transmission, withdrawal at different times after delivery had no effect on postpartum liver function. ALT flare during pregnancy is a risk factor for postpartum ALT flare, so TDF should be discontinued carefully and liver function should be closely monitored postpartum for such patients.
