Efficacy comparison of lamivudine and telbivudine combined with hepatitis B vaccine in blocking vertical transmission of hepatitis B virus

Abstract

Objective To compare the efficacy of lamivudine and telbivudine combined with hepatitis B vaccine in blocking vertical transmission of hepatitis B virus (HBV) in pregnant women with HBV infection during late stage of pregnancy. Methods From January 2010 to December 2013, 195 pregnant women with HBV infection who received prenatal examination and institutional delivery were enrolled and randomized into three groups based on random number table method, lamivudine group, telbivudine group and control group, 65 cases in each group. The subjects in lamivudine group and telbivudine group orally took lamivudine 100 mg/d and telbivudine 600 mg/d respectively,from the 28th week of gestation to 1 month after delivery. The primary end point was HBsAg positivity of infants at 12 months of age. Results Serum lgHBV DNA level of mothers in lamivudine group was 3.7±1.2, and in telbivudine group was 3.6±1.5, in control group was 8.4±1.7. The serum lgHBV DNA level of mothers in lamivudine group and telbivudine group was significantly lower than that in control group (P <0.01). HBsAg positivity rate of infants at 12 months of age in lamivudine group was 3.1% (2/65), in telbivudine group was 4.6% (3/65), and in control group was 15.4% (10/65). HBsAg positivity rate of infants at 12 months of age in lamivudine group and telbivudine group was significantly lower than that in control group (P <0.05). Conclusion Lamivudine and telbivudine are both effective in preventing vertical transmission of HBV for pregnant women with HBV infection in late stage of pregnancy, and further clinical study is required. Key words: Hepatitis B virus; Lamivudine; Maternal-neonatal transmission; Telbivudine