Clinical course and perinatal transmission of chronic hepatitis B during pregnancy in a real-life setting: A prospective cohort study

Summary Objective To determine the clinical course and perinatal transmission of chronic hepatitis B during pregnancy in a real life setting. Methods A total of 221 singleton pregnant women with detectable HBV-DNA levels (≥103 copies/mL) were enrolled during January 2011 to June 2015. Forty-three hi...

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Published in:The Journal of infection 2017
Main Authors: Chen, Zhi-Xian, Gu, Gui-Fang, Bian, Zhao-Lian, Cai, Wei-Hua, Shen, Yi, Hao, Yan-Li, Zhang, Sheng, Shao, Jian-Guo, Qin, Gang
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Infectious Disease
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container_title The Journal of infection
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creator Chen, Zhi-Xian
Gu, Gui-Fang
Bian, Zhao-Lian
Cai, Wei-Hua
Shen, Yi
Hao, Yan-Li
Zhang, Sheng
Shao, Jian-Guo
Qin, Gang
description Summary Objective To determine the clinical course and perinatal transmission of chronic hepatitis B during pregnancy in a real life setting. Methods A total of 221 singleton pregnant women with detectable HBV-DNA levels (≥103 copies/mL) were enrolled during January 2011 to June 2015. Forty-three high viraemic patients (≥ 106 copies/mL) received telbivudine in the 2nd or 3rd trimester according to their intention, while 89 high viraemic and 79 low viraemic (≥103 and
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Methods A total of 221 singleton pregnant women with detectable HBV-DNA levels (≥103 copies/mL) were enrolled during January 2011 to June 2015. Forty-three high viraemic patients (≥ 106 copies/mL) received telbivudine in the 2nd or 3rd trimester according to their intention, while 89 high viraemic and 79 low viraemic (≥103 and &lt;106 copies/mL) patients were the control cohorts. Primary endpoint was the pregnancy outcomes and secondary endpoint the perinatal transmission including intrauterine infection, immunoprophylaxis failure and occult infection. Results In all, 209 patients completed pregnancy with 209 infants, while 2 in telbivudine-treated cohort had unexplained late stillbirths. Twenty-nine (70.7%) of telbivudine-treated patients and 3 (3.4%) of untreated high viraemic controls achieved undetectable HBV-DNA levels prior delivery. At 7 months postpartum, immunoprophylaxis failure was significantly lower (2.4%) in telbivudine-treated cohort, compared with 16.9% and 10.1% in untreated high and low viraemic cohorts, respectively. Conclusions Low viraemic patients may also need antiviral therapy since they bear moderate risk for perinatal transmission of HBV. However, more multicenter, large-scale studies are required before antepartum antiviral therapy is routinely recommended in patients with detectable viral loads.</description><identifier>ISSN: 0163-4453</identifier><identifier>DOI: 10.1016/j.jinf.2017.05.012</identifier><language>eng</language><subject>Infectious Disease</subject><ispartof>The Journal of infection, 2017</ispartof><rights>The British Infection Association</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,4024,27923,27924,27925</link.rule.ids></links><search><creatorcontrib>Chen, Zhi-Xian</creatorcontrib><creatorcontrib>Gu, Gui-Fang</creatorcontrib><creatorcontrib>Bian, Zhao-Lian</creatorcontrib><creatorcontrib>Cai, Wei-Hua</creatorcontrib><creatorcontrib>Shen, Yi</creatorcontrib><creatorcontrib>Hao, Yan-Li</creatorcontrib><creatorcontrib>Zhang, Sheng</creatorcontrib><creatorcontrib>Shao, Jian-Guo</creatorcontrib><creatorcontrib>Qin, Gang</creatorcontrib><title>Clinical course and perinatal transmission of chronic hepatitis B during pregnancy in a real-life setting: A prospective cohort study</title><title>The Journal of infection</title><description>Summary Objective To determine the clinical course and perinatal transmission of chronic hepatitis B during pregnancy in a real life setting. Methods A total of 221 singleton pregnant women with detectable HBV-DNA levels (≥103 copies/mL) were enrolled during January 2011 to June 2015. Forty-three high viraemic patients (≥ 106 copies/mL) received telbivudine in the 2nd or 3rd trimester according to their intention, while 89 high viraemic and 79 low viraemic (≥103 and &lt;106 copies/mL) patients were the control cohorts. Primary endpoint was the pregnancy outcomes and secondary endpoint the perinatal transmission including intrauterine infection, immunoprophylaxis failure and occult infection. Results In all, 209 patients completed pregnancy with 209 infants, while 2 in telbivudine-treated cohort had unexplained late stillbirths. Twenty-nine (70.7%) of telbivudine-treated patients and 3 (3.4%) of untreated high viraemic controls achieved undetectable HBV-DNA levels prior delivery. At 7 months postpartum, immunoprophylaxis failure was significantly lower (2.4%) in telbivudine-treated cohort, compared with 16.9% and 10.1% in untreated high and low viraemic cohorts, respectively. Conclusions Low viraemic patients may also need antiviral therapy since they bear moderate risk for perinatal transmission of HBV. 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Methods A total of 221 singleton pregnant women with detectable HBV-DNA levels (≥103 copies/mL) were enrolled during January 2011 to June 2015. Forty-three high viraemic patients (≥ 106 copies/mL) received telbivudine in the 2nd or 3rd trimester according to their intention, while 89 high viraemic and 79 low viraemic (≥103 and &lt;106 copies/mL) patients were the control cohorts. Primary endpoint was the pregnancy outcomes and secondary endpoint the perinatal transmission including intrauterine infection, immunoprophylaxis failure and occult infection. Results In all, 209 patients completed pregnancy with 209 infants, while 2 in telbivudine-treated cohort had unexplained late stillbirths. Twenty-nine (70.7%) of telbivudine-treated patients and 3 (3.4%) of untreated high viraemic controls achieved undetectable HBV-DNA levels prior delivery. At 7 months postpartum, immunoprophylaxis failure was significantly lower (2.4%) in telbivudine-treated cohort, compared with 16.9% and 10.1% in untreated high and low viraemic cohorts, respectively. Conclusions Low viraemic patients may also need antiviral therapy since they bear moderate risk for perinatal transmission of HBV. However, more multicenter, large-scale studies are required before antepartum antiviral therapy is routinely recommended in patients with detectable viral loads.</abstract><doi>10.1016/j.jinf.2017.05.012</doi></addata></record>
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title Clinical course and perinatal transmission of chronic hepatitis B during pregnancy in a real-life setting: A prospective cohort study
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