Telbivudine can safely reduce mother-to-child transmission in chronic hepatitis B women after 12 weeks of gestation

Han, Lijing; Zheng, Jianming; Zheng, Liqing; Gao, Haibing; Chen, Lixia; Xu, Qingling; Chai, Yihong; Zhang, Xin; Chen, Pan; Yao, Lvfeng

doi:10.1186/s12879-019-4250-6

Cited by 4 publications

(5 citation statements)

References 30 publications

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“…This is consistent with the published studies that LdT did not cause infant birth defects. [4,15,17,18,20] In our study, we believe the reduced MTCT rate of HBV in infants could be attributed to the lowing reasons: (a) signi cantly reduced maternal viral load by LdT before delivery; and (b) timely administration of hepatitis B vaccine and hepatitis B immune globulin (within 2 hours of delivery).…”

Section: Discussionmentioning

confidence: 73%

“…Since the rst 3 months are the critical time for fetal development, exposure to drugs at this time may carry a higher risk of deformity. Considering that antiviral treatment requires several weeks to effectively suppress serum viral loads, [4] we propose that pregnant women in the immune-tolerant phase should take oral antiviral drugs at 28-32 weeks of gestation in order to effectively and safely block MTCT of HBV.…”

Section: Discussionmentioning

confidence: 99%

“…The combination of passive and active immunization after birth reduces the rates of MTCT from 90-10%. [4,5] At present in China, over 90% of infants receive birth-dose vaccination. [3] However, there is still a risk of failure in immunization prevention.…”

Section: Introductionmentioning

confidence: 99%

“…[1,2] Ltd. is a class B drug approved by the US Food and Drug Administration for the treatment of adult patients with CHB, [9] and its safety and effectiveness in blocking MTCT of HBV have been con rmed in many studies. [4,[10][11][12] According to the guidelines of the Asian Paci c Association for the Study of the Liver, Ltd. can be used as a replacement antiviral agent during pregnancy. [9] However, the suitable time to perform antiviral therapy still controversial.…”

Section: Introductionmentioning

confidence: 99%

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Efficacy and Safety of Telbivudine in Preventing Mother-to-Child Transmission of Hepatitis B Virus

Chen¹,

Yun-lei²,

Zhao³

et al. 2021

Preprint

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Background: To define the best timing for the treatment of high maternal viral DNA levels in order to block the mother-to-child transmission (MTCT).Methods: From a total of 820 HBsAg-positive pregnant women, 229 who satisfied the selection criteria were enrolled for the final analysis. These patients were divided into thress groups: Group A: 62 patients received telbivudine (LdT) (600 mg/day, orally) treatment before pregnant; Group B: 101 patients received LdT treatment at 24-28 weeks of gestation; and Group C: 66 patienst with high viral load received LdT at the third trimester. All infants born to the enrolled women were vaccinated with 100 IU of hepatitis B immune globulin (HBIG) and 10 μg of hepatitis B vaccine within 2 hours of birth. The second and third does of recombinant HBV vaccine were administered at 1 and 6 months of age, respectively.Results: LdT can effectively reduce serum HBV DNA and normalize ALT levels before delivery (p<0.001). The HBsAg positivity rate in infants in Groups A, B and C after delivery was 1.6%, 7.9% and 3.0%, respectively. The serum HBV DNA positivity rate in infants in Groups A, B and C after delivery was 4.8%, 5.0% and 0%, respectively. After 28 weeks of follow up, all infants remained HBV DNA and/or HBSag negative. No serious adverse events were found in the mothers or their infants treated with LdT.Conclusions: Telbivudine (LdT) given at the 28-32 weeks of gestation can effectively reduce mother-to-child transmission in HBV-infected women with good safety.

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Section: Discussionmentioning

confidence: 73%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Efficacy and Safety of Telbivudine in Preventing Mother-to-Child Transmission of Hepatitis B Virus

Chen¹,

Yun-lei²,

Zhao³

et al. 2021

Preprint

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“…Close check of transaminase levels is needed after the end of treatment. Lamivudine[ 41 ], telbivudine[ 42 ], and tenofovir disoproxil fumarate[ 43 ] are the antiretroviral drugs that are considered safe to use during pregnancy. Telbivudine and lamivudine could significantly reduce transmission in infants compared with cases with no treatment, but both drugs have a low genetic barrier to resistance barrier.…”

Section: Prevention Of Vertical Transmission Of Hbv: Management Strategies During Pregnancymentioning

confidence: 99%

Prevention of vertical transmission of hepatitis B virus infection

Veronese

Dodi

Esposito

et al. 2021

WJG

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Hepatitis B virus (HBV) is the leading cause of chronic viral hepatitis. Annually, almost two million children younger than 5 years acquire the infection, mostly through vertical or horizontal transmission in early life. Vertical transmission of HBV is a high efficacy phenomenon ranging, in the absence of any preventive interventions, from 70% to 90% for hepatitis e antigen positive mothers and from 10% to 40% for hepatitis e antigen-negative mothers. Maternal viraemia is a preeminent risk factor for vertical transmission of HBV. Maternal screening is the first step to prevent vertical transmission of HBV. Hepatitis B passive and active immunoprophylaxis at birth together with antiviral treatment of highly viraemic mothers are the key strategies for global elimination of HBV infection. Strategies are needed to promote implementation of birth-dose vaccination and hepatitis B immunoglobulins in low- and middle-income countries where the prevalence of the infection is at the highest.

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Hepatitis B Virus Infection in Pregnancy: An Update on Evidence-Based Management

Sirilert¹,

Tongsong

2020

Obstetrical &Amp; Gynecological Survey

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Importance Vertical hepatitis B virus (HBV) transmission is the important route of chronic HBV infection. Although infant immunoprophylaxis is effective, a significant number of infants still become infected, most are associated with intrauterine infection. New evidences support intrauterine treatment in cases of high risk. Objective The aim of this study was to review the current evidences and recommendations for management of HBV infection in pregnancy. Evidence Acquisition Original research articles, review articles, and guidelines were reviewed. Results The management can be summarized as follows: (1) all pregnant women should be screened for hepatitis B surface antigen (HBsAg) and antibody to HBsAg. High-risk HBsAg-negative pregnant women without immunity should be vaccinated during pregnancy. (2) HBsAg-positive pregnant women should undergo further workup for liver status and indicative factors for immunoprophylaxis failure. (3) Pregnant women should be treated with HBV DNA levels greater than 200,000 IU/mL or 6 log copies/mL. (4) Antiviral drug should be started around 28 to 32 weeks. The first-line drug is tenofovir disoproxil fumarate. (5) Delivery route should be chosen based only on obstetric indications. (6) Breastfeeding is not contraindicated because it does not increase the risk of transmission in neonates with HBV vaccine and immunoglobulin administration. (7) Neonates born to HBsAg-positive mothers should receive HBV vaccine and immunoglobulin after birth as soon as possible. (8) Follow-up of the mothers and neonates is important. Beware of hepatitis flare after birth and after antiretroviral drug discontinuation; alanine transaminase assessment every 1 to 3 months until 6 months is suggested. Also, the schedule of infant vaccination and follow-up of serologic testing at 9 to 12 months old is needed. Target Audience Obstetricians and gynecologists, family physicians Learning Objectives After the completion of this review, the learners should be better able to summarize updated knowledge of infant immunoprophylaxis failure; outline how to manage pregnancy with HBV infection, both antepartum and postpartum period; and describe advantages and disadvantages of the commonly used antiviral drugs.

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Telbivudine can safely reduce mother-to-child transmission in chronic hepatitis B women after 12 weeks of gestation

Cited by 4 publications

References 30 publications

Efficacy and Safety of Telbivudine in Preventing Mother-to-Child Transmission of Hepatitis B Virus

Efficacy and Safety of Telbivudine in Preventing Mother-to-Child Transmission of Hepatitis B Virus

Prevention of vertical transmission of hepatitis B virus infection

Hepatitis B Virus Infection in Pregnancy: An Update on Evidence-Based Management

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