Abstract
Few studies were conducted to assess safety and efficacy of continuous antiviral therapy administrated from preconception. In the present study, 136 eligible women with chronic HBV infection were recruited, and assigned to active chronic hepatitis B (CHB) (Group A, B or C) or chronic HBV carrier (Group D). Antiviral therapy was administrated in preconception (Group A), in early (Group B) or late pregnancy (Group C and Group D). Immunoprophylaxis was administrated to all infants. Mothers’ HBV status and ALT were assessed at delivery and 7 months postpartum. Offspring’s HBV status was examined at 7 months old. Group A women showed low HBV DNA level and normal ALT throughout pregnancy. All women at delivery had an HBV DNA level of less than 106 IU/ml, but the proportion of patients with lower HBV DNA level in Group A was higher than any of other three groups (P < 0.05). No differences in obstetrical complications were found among the four groups. None of infants who completed follow-up showed positive HBsAg at age of 7 months. Congenital malformation and infant growth indicators were similar among study cohorts. Continuous antiviral therapy from preconception to entire pregnancy is effective and safe for active CHB mothers and their infants.
Highlights
Chronic HBV infection, a major cause for cirrhosis and hepatocellular carcinoma (HCC), remains an important public health issue worldwide, in Asia and A frica[1]
We focused on the active chronic hepatitis B (CHB) patients and chronic HBV carriers with high HBV DNA level, as they all should be given antiviral therapy to control hepatitis flare and reduce MTCT of HBV
Our findings suggest that continuous antiviral treatment from preconception through the entire pregnancy is safe for active CHB mothers and their infants
Summary
Chronic HBV infection, a major cause for cirrhosis and hepatocellular carcinoma (HCC), remains an important public health issue worldwide, in Asia and A frica[1]. Some child-bearing women with active chronic hepatitis B (CHB) should take oral antiviral drugs in preconception, because antiviral treatment for chronic HBV infection could control hepatitis flare and reduce the incidence of cirrhosis, HCC, and d eath[16,17]. These patients have to take oral antiviral drugs for a long time period, even lifelong, because oral antiviral drugs only inhibit HBV rather than kill HBV.
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