Comparison the efficacy of tenofovir disoproxil fumarate vs telbivudine during the third trimester in pregnant women with high viral load of hepatitis B virus in maternal-infant blocking and infant vaccine immune responses

doi:10.19871/j.cnki.xfcrbzz.2022.01.007

Abstract

Abstract: Objective To observe the efficacy of tenofovir disoproxil fumarate (TDF) and telbivudine (LdT) treatment during the third trimester in preventing mother-to-child transmission of hepatitis B virus (HBV) and the immune response to hepatitis B vaccine in infants aged 12 months and 24 months,provide reference for mother to child interruption of hepatitis B. Method 189 mothers with both hepatitis B surface antigen (HBsAg)and Hepatitis B e-antigen (HBeAg) positive and high viral load (HBV DNA≥1.0×10⁶copies/ml) who delivered at the Second Hospital of Nanjing from January 2016 to December 2018 were enrolled in this study. Pregnant women were divided into three groups according to therapy strategy: A group, TDF treatment group (61 pregnancies); B group, LdT treatment group (97 pregnancies); C group, non-antiviral treatment group (31 pregnancies). The viral load and HBeAg titer of pregnant women before medication and delivery were observed HBsAb titer of 150 infants aged 12 months and 24 months were followed up. Statistical analysis was performed using SPSS 25.0 software. Result The viral load and HBeAg titer of A and B group were both decreased. There were statistical difference before medication and before delivery within group A and B (P<0.05), while no statistical difference existed between the two groups (P>0.05). The level of HBV DNA and HBeAg of group C before delivery was not statistically different from that before medication (P>0.05). No infant in A or B group was infected with HBV with a 100% blocking rate. There was one infant in C group infected with HBV through intrauterine infection,therefore the success rate of mother-to-child transmission blocking in C group was 96.8%. We compared HBeAb titer of infants aged 12 months who had responded actively to hepatitis B vaccine among three groups and found no statistical difference (P>0.05). HBeAb titer of infants aged 24 months in group A was higher than other groups with statistical differences(P<0.05). There was no obvious adverse reaction to either drug. Conclusion TDF and LdT used at third trimester for mothers is safe and effective in blocking mother-to-child transmission with a high blocking rate. Infants in all groups responded actively to the combined immunoprophylaxis.

Key words: Hepatitis B virus, Hepatitis B vaccine, Mother-to-child transmission, Blockage

Shi Jinmei, Yang Lixin, Bai Shufen. Comparison the efficacy of tenofovir disoproxil fumarate vs telbivudine during the third trimester in pregnant women with high viral load of hepatitis B virus in maternal-infant blocking and infant vaccine immune responses[J]. Electronic Journal of Emerging Infectious Diseases, 2022, 7(1): 30-33.

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