Comparison of telbivudine versus lamivudine in interrupting perinatal transmission of hepatitis B virus

Yu, Min-Min; Qian, Jiang; Ji, Ying; Wu, K.; Ju, Lin; Tang, Xun; Yang, Yue

doi:10.1016/j.jcv.2014.06.005

Cited by 28 publications

(33 citation statements)

References 13 publications

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“…Of the 32 RCTs that enrolled 4189 pregnant women, 17 studies evaluated the effect of LAM, 15 studies evaluated LdT, 3 studies evaluated TDF, and 3 studies evaluated both LAM and LdT . Of the 27 non‐RCT studies enrolling 5039 pregnant women, 10 evaluated LAM, 18 evaluated LdT, 3 studies evaluated TDF, 2 evaluated both LAM and LdT, and another 2 studies evaluated both LAM and TDF . The characteristics of pregnant women and newborns in the 59 studies are summarized in Table .…”

Section: Resultsmentioning

confidence: 99%

Efficacy and safety of antiviral treatment on blocking the mother‐to‐child transmission of hepatitis B virus: A meta‐analysis

Song

Yang

Wang

et al. 2018

Journal of Viral Hepatitis

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Summary Nucleo(t)side analogues (NAs) have been administered as adjunctive therapy to interrupt the mother‐to‐child transmission (MTCT) of hepatitis B virus (HBV). The efficacy and safety of this method remain controversial. A meta‐analysis was conducted to evaluate the efficacy and safety of NAs treatment during pregnancy. The differences among different agents and initiation trimesters were analysed. A total of 9228 mother‐infant pairs in 59 studies (32 RCTs and 27 non‐RCTs) were included in this meta‐analysis. NAs significantly reduced the risk of MTCT, as indicated by seropositivity of hepatitis B surface antigen (HBsAg) (risk ratio (RR) = 0.51, 95% confidence interval (CI) 0.45‐0.57) and HBV DNA in newborns (RR = 0.22, 95% CI 0.18‐0.26). No differences in the efficacy of interrupting HBV MTCT were evident among lamivudine, telbivudine and tenofovir disoproxil fumarate. NA was more effective when administered from the second than from the third trimester as indicated by HBV DNA (RR: the second vs the third 0.08 vs 0.22, P = 0.010), but this effect was not evident as indicated by HBsAg (RR: the second vs the third 0.46 vs 0.53, P = 0.596). Antiviral treatment initiated from the second trimester did not confer a higher risk of safety problems in the newborns compared with treatment from the third trimester, as indicated by weight (P = 0.064), length (P = 0.491) and malformation rate (P = 0.635) of newborns. Conclusions Lamivudine, telbivudine and tenofovir disoproxil fumarate are equally effective in blocking HBV MTCT. Antiviral treatment can be applied from the second trimester, without obvious safety concerns.

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Section: Resultsmentioning

confidence: 99%

Efficacy and safety of antiviral treatment on blocking the mother‐to‐child transmission of hepatitis B virus: A meta‐analysis

Song

Yang

Wang

et al. 2018

Journal of Viral Hepatitis

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“…Lamivudine is a category C nucleoside analog that decreases maternal viral load by competitively inhibiting HBV reverse transcriptase 19,30. Several studies have demonstrated greater than 50% reduction in VT rate in those women treated with lamivudine versus untreated women 4,6.…”

Section: Hbvmentioning

confidence: 99%

“…Telbivudine is a category B nucleoside analog that selectively inhibits HBV polymerase and thereby suppresses HBV replication 30. A number of studies have demonstrated that telbivudine is more effective than lamivudine at reducing maternal viral load 6,12,30,35,41.…”

Section: Hbvmentioning

confidence: 99%

“…A number of studies have demonstrated that telbivudine is more effective than lamivudine at reducing maternal viral load 6,12,30,35,41. A study comparing mothers treated with lamivudine versus telbivudine found HBsAg positivity in their children in 18% and 2% respectively 6.…”

Section: Hbvmentioning

confidence: 99%

“…A study comparing mothers treated with lamivudine versus telbivudine found HBsAg positivity in their children in 18% and 2% respectively 6. Another study compared the viral load in pregnant women at 4–8 weeks after initiation of antiviral therapy, finding HBV DNA to be undetectable in 36.5% in those treated with tebivudine and 20.1% in the lamivudine group 30. These findings, in concert with the increased resistance against lamivudine, underscore telbivudine as the superior drug.…”

Section: Hbvmentioning

confidence: 99%

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Mechanisms and Prevention of Vertical Transmission in Chronic Viral Hepatitis

Mavilia¹,

Wu²

2017

Journal of Clinical and Translational Hepatology

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Vertical transmission (VT) is the primary route of transmission of viral hepatitis in children. The rate of VT ranges from 1–28% with hepatitis B virus (HBV) and 3–15% with hepatitis C virus (HCV). VT for both viruses can occur during the intrauterine or peripartum period. VT of HBV primarily occurs by intrauterine transmission (IUT). Hepatitis B surface antigen is unable to cross the placenta and, therefore, relies on processes like transplacental leakage, placental infection, cellular transmission by peripheral blood mononuclear cells, and germline transmission. HCV can also infect the fetus by IUT. Both viruses also have the potential for transmission during delivery, when there is increase chance of maternal–fetal blood exposure. HBV and HCV share some common risk factors for VT, including maternal viral load, human immunodeficiency virus co-infection and neonatal sex. Prevention of VT differs greatly between HBV and HCV. There are several alternatives for prevention of HBV VT, including antiviral medications during the third trimester of pregnancy and HBV vaccine, as well as hepatitis B immunoglobulin administration to infants post-partum. In contrast, there are no preventative interventions available for HCV. Despite these differences, the key to prevention with both viruses is screening women prior to and during pregnancy.

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Efficacy of maternal tenofovir disoproxil fumarate in interrupting mother‐to‐infant transmission of hepatitis B virus

et al. 2015

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The efficacy and safety of maternal tenofovir disoproxil fumarate (TDF) in reducing mother-to-infant hepatitis B virus (HBV) transmissions is not clearly understood. We conducted a prospective, multicenter trial and enrolled 118 hepatitis B surface antigen (HBsAg)-and hepatitis B e antigen-positive pregnant women with HBV DNA 7.5 log 10 IU/mL. The mothers received no medication (control group, n 5 56, HBV DNA 8.22 6 0.39 log 10 IU/mL) or TDF 300 mg daily (TDF group, n 5 62, HBV DNA 8.18 6 0.47 log 10 IU/mL) from 30-32 weeks of gestation until 1 month postpartum. Primary outcome was infant HBsAg at 6 months old. At delivery, the TDF group had lower maternal HBV DNA levels (4.29 6 0.93 versus 8.10 6 0.56 log 10 IU/mL, P < 0.0001). Of the 121/123 newborns, the TDF group had lower rates of HBV DNA positivity at birth (6.15% versus 31.48%, P 5 0.0003) and HBsAg positivity at 6 months old (1.54% versus 10.71%, P 5 0.0481). Multivariate analysis revealed that the TDF group had lower risk (odds ratio 5 0.10, P 5 0.0434) and amniocentesis was associated with higher risk (odds ratio 6.82, P 5 0.0220) of infant HBsAg positivity. The TDF group had less incidence of maternal alanine aminotransferase (ALT) levels above two times the upper limit of normal for 3 months (3.23% versus 14.29%, P 5 0.0455), a lesser extent of postpartum elevations of ALT (P 5 0.007), and a lower rate of ALT over five times the upper limit of normal (1.64% versus 14.29%, P 5 0.0135) at 2 months postpartum. Maternal creatinine and creatinine kinase levels, rates of congenital anomaly, premature birth, and growth parameters in infants were comparable in both groups. At 12 months, one TDF-group child newly developed HBsAg positivity, presumably due to postnatal infection and inefficient humoral responses to vaccines. Conclusions: Treatment with TDF for highly viremic mothers decreased infant HBV DNA at birth and infant HBsAg positivity at 6 months and ameliorated maternal ALT elevations. (HEPATOLOGY 2015;62:375-386) D espite the 75%-90% reduction of chronic hepatitis B viral (HBV) infection following universal infant immunization, active/passive immunoprophylaxis has not eradicated mother-toinfant HBV transmission. [1][2][3][4] Approximately 10% of chronic HBV infections cannot be prevented.5-7 The major risks of chronic HBV infection in the immunization era are maternal hepatitis B surface antigen (HBsAg)/hepatitis B e antigen (HBeAg) positivity and high maternal viral load.5-9 Moreover, after immunoprophylaxis, children with HBV infection have a higher risk of developing hepatocellular carcinoma. 10,11 To achieve the goal of global eradication of HBV infection, better strategies aimed at interrupting Abbreviations: ALT, alanine aminotransferase; anti-HBs, antibody to hepatitis B surface antigen; D0, day 0, initiation of TDF treatment (baseline); D1M, 1 month after TDF treatment; HBeAg, hepatitis B e antigen; HBsAg, hepatitis B surface antigen; HBV, hepatitis B virus; P0, at partum; PXM, X months postpartum; SNR, signal-to-noise ratio; TDF, tenofov...

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Comparison of telbivudine versus lamivudine in interrupting perinatal transmission of hepatitis B virus

Cited by 28 publications

References 13 publications

Efficacy and safety of antiviral treatment on blocking the mother‐to‐child transmission of hepatitis B virus: A meta‐analysis

Efficacy and safety of antiviral treatment on blocking the mother‐to‐child transmission of hepatitis B virus: A meta‐analysis

Mechanisms and Prevention of Vertical Transmission in Chronic Viral Hepatitis

Efficacy of maternal tenofovir disoproxil fumarate in interrupting mother‐to‐infant transmission of hepatitis B virus

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