替诺福韦酯阻断乙肝母婴传播的疗效评价

张玉蓉; 彭孟云; 尹玥; 汪静

doi:10.3969/j.issn.2096-3351.2022.02.009

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替诺福韦酯阻断乙肝母婴传播的疗效评价

更新时间：2023-05-05

- 替诺福韦酯阻断乙肝母婴传播的疗效评价
- Efficacy and safety of tenofovir disoproxil fumarate in blocking mother-to-child transmission of hepatitis B
- 西南医科大学学报 2022年45卷第2期页码：131-134
- 作者机构：
  
  西南医科大学附属中医医院肝胆病科,泸州,646000
- 作者简介：
- 基金信息：
- DOI：10.3969/j.issn.2096-3351.2022.02.009
  中图分类号：
- 纸质出版日期：2022，
  
  网络出版日期：2022-3-20，
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张玉蓉, 彭孟云, 尹玥, 等. 替诺福韦酯阻断乙肝母婴传播的疗效评价[J]. 西南医科大学学报, 2022,45(2):131-134.

ZHANG Yurong, PENG Mengyun, YIN Yue, et al. Efficacy and safety of tenofovir disoproxil fumarate in blocking mother-to-child transmission of hepatitis B[J]. Journal of Southwest Medical University, 2022,45(2):131-134.
张玉蓉, 彭孟云, 尹玥, 等. 替诺福韦酯阻断乙肝母婴传播的疗效评价[J]. 西南医科大学学报, 2022,45(2):131-134. DOI： 10.3969/j.issn.2096-3351.2022.02.009.

ZHANG Yurong, PENG Mengyun, YIN Yue, et al. Efficacy and safety of tenofovir disoproxil fumarate in blocking mother-to-child transmission of hepatitis B[J]. Journal of Southwest Medical University, 2022,45(2):131-134. DOI： 10.3969/j.issn.2096-3351.2022.02.009.

摘要

目的探讨慢性乙型肝炎孕妇妊娠中晚期口服替诺福韦酯（tenofvir disoproxil fumarate，TDF）阻断乙型肝炎病毒母婴传播的疗效与安全性。方法选取2017 年9 月至2019 年6 月于本院肝胆病科门诊接受TDF 抗病毒治疗的慢性乙肝中晚期孕妇30 例，连续用药至分娩当天停药，新生儿出生后均采取标准的免疫预防措施。对比孕妇TDF 治疗前、分娩前及停药后ALT、AST 及HBV DNA 载量水平，并观测乙肝病毒在母婴之间的阻断情况及停药后母亲的安全性等。结果经TDF 治疗后，孕妇分娩前ALT 及AST 水平差异均无统计学意义（P＞0.05），HBVDNA 载量水平较基线水平明显下降，差异具有统计学意义（P＜0.05）。入组孕妇所产新生儿随访期12 月内血清HBsAg 阳性率为0%，母婴阻断率达100%，且新生儿生长发育状况良好，未见畸形及发育异常。停药后1 ~ 3 月内，产妇HBV DNA 载量水平逐渐升高到产前水平，至停药后12月，共计7 例产妇出现肝功能异常（23.33%），其中2 例轻度升高，未予治疗自行缓解，5 例（16.67%）重新给予抗乙肝病毒治疗后恢复正常。结论孕中晚期口服TDF 抗病毒治疗能够有效且安全地阻断HBV 的母婴传播，分娩后立即停药有一定肝功能异常风险，但予以规范治疗后病情可控，安全性较好。

Abstract

Objective To investigate the efficacy and safety of oral tenofovir disoproxil fumarate（TDF）in blocking moth-er-to-child transmission of hepatitis B virus（HBV）in pregnant women with chronic hepatitis B in the second and third trimesters of pregnancy. Methods Thirty pregnant women with chronic hepatitis B who received TDF for antiviral therapy in the Hepatobiliary Clin-ic of our hospital from September 2017 to June 2019 were selected. They received continuous administration until the day of delivery. Standard immunoprophylaxis measures were taken for all newborns after birth. The levels of alanine aminotransferase（ALT）

aspartate aminotransferase（AST）

and HBV DNA load of pregnant women before TDF treatment

before delivery

and after drug withdrawal were compared. The blocking of HBV from mother to child and the safety of mother after drug withdrawal were observed. Results After TDF treatment

the ALT and AST levels of pregnant women before delivery showed no significant changes from baseline（P > 0.05）

and the HBV DNA load level was significantly reduced compared with the baseline level（P < 0.05）. The positive rate of serum hepatitis B sur-face antigen of newborns from the enrolled pregnant women was 0% within 12 months of follow-up

reaching a maternal-infant blocking rate of 100%. Moreover

the newborns were in good growth and development

without malformation or developmental abnormality. With-in 1 ~ 3 months after drug withdrawal

the HBV DNA load level of puerperae gradually increased to the prenatal level. By 12 months af-ter drug withdrawal

a total of 7 puerperae（23.33%）showed abnormal liver function

among whom 2 puerperae showed mild elevation and spontaneous remission without treatment

and 5 puerperae（16.67%）returned to normal after re-administration of anti-HBV treat-ment. Conclusion Oral TDF for antiviral therapy in the second and third trimesters of pregnancy can effectively and safely block the mother-to-child transmission of HBV. Immediate drug withdrawal after delivery can bring a certain risk of liver function abnormality

while the disease can be controlled after standard treatment.

关键词

替诺福韦酯乙型肝炎病毒母婴传播安全性

Keywords

Tenofovir disoproxil fumarateHepatitis B virusMother-to-child transmissionSafety

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