Background and Aim: The efficacy of telbivudine for breaking vertical transmission of hepatitis B virus has been well established. Data on the risk of postpartum flare after telbivudine withdrawal and efficacy of extended antiviral therapy after delivery are limited. Methods: Chronic hepatitis B virus-infected women who received telbivudine beginning at week 24 or 28 of gestation were enrolled and then followed up to 52 weeks postpartum. Virological and biochemical parameters were assessed. Results: Of the 241 women who finished 52 weeks of follow-up, 33.6% had elevated serum alanine aminotransferase (ALT) during pregnancy. Telbivudine administration resulted in ALT normalization in 85.2% before delivery. Compared with women having a normal ALT level throughout pregnancy, those with elevated ALT had a significantly higher rate of ALT flare after telbivudine withdrawal (25.0% vs 11.9%; χ 2 = 4.273, P = 0.039). Multivariate analysis indicated that only ALT elevation during pregnancy correlated with postpartum flare after telbivudine withdrawal. Those women with elevated ALT during pregnancy continued antiviral treatment to 52 weeks postpartum and had a significantly higher HBeAg seroconversion rate (P = 0.001) and a notable decrease in HBsAg titers (P = 0.001). Conclusion: It is safe for the majority of women to withdraw telbivudine after delivery, whereas exciting serological response encourages extended antiviral therapy for mother with ALT elevation during pregnancy.

The effect of hepatitis B immunoglobulin (HBIG) on hepatitis B virus (HBV) DNA load and its protective mechanism are not well understood. Twenty-eight hepatitis B surface antigen (HBsAg)–positive pregnant women and their newborns were assigned to an experimental (n = 12) or control group (n = 16) according to whether they received HBIG during pregnancy. HBV DNA load and markers titer of the mothers and newborns were tested. These markers and HBV DNA load in mothers of the experimental group did not fluctuate significantly and were comparable to the control. In the experimental group, there was a positive correlation between mothers and their newborns with regard to hepatitis B surface antibody titer. Immunohistochemical staining of placenta sections showed that HBsAg-positive areas mainly included trophoblastic cells and villous mesenchymal cells without HBIG colocalization, whereas HBIG-positive areas principally included villous capillary endothelial cells and villous mesenchymal cells. Additionally, compared with the control group, the positive rate and mean density of HBIG in the experimental group were remarkably higher. HBIG deposition was seen in Hofbauer cells. Thus, rather than influencing virus replication, HBIG forms an immune barrier between the mother and fetus to prevent HBV transmission.

No abstract

No response to HB vaccine in infants of HBsAg(+) mothers was associated to the transplacental transfer of HBsAg.

The basic fibroblast growth factor (bFGF) has a special role in improving proliferation and differentiation of fiber cells in growth of muscle. The function of bFGF with magnetic nanoparticles (MNPs) on regeneration and recovery of rats’ dampened skeletal muscle and expression of MMPS were studied in our research. The MNPs packed with bFGF were prepared and 95 experimental rats were selected. These 30 rats were equally divided into control group, model group (self-healing without obstruction after model was established), bFGF group (disposed with bFGF packaged with MNP). The contractility and stress relaxation of rats’ skeletal muscle were observed at the 48th h, 10th, 17th, 24th and 30th days after damage. The remaining 65 rats were divided randomly into control group (5 rats) and experimental group (60 rats intervened with MNPs packaged with bFGF). The groups were randomly divided into 0.5 h, 1 h, 3 h, 6 h, 12 h, 1 d, 2 d, 3 d, 4 d, 7 d, 10 d and 14 d according to different executed time. The levels of bFGF and MMPS were detected by HE staining method and immunohistochemical staining. There was a significant declining tendency of shrinkage stress of muscle in the model, sham-operation, BSA and bFGF groups compared with control group in the second day. The contractility after contusion wound in the regeneration and recovery of rats’ skeletal muscle was effectively alleviated with MNPs packaged with bFGF.