The postpartum changes of liver function after telbivudine treatment in preventing mother-to-child transmission of hepatitis B virus infection during pregnancy

doi:10.3877/cma.j.issn.1674-1358.2016.03.018

Abstract

Abstract:

Objective

To investigate the changes of liver function of woman with higher quantities of antepartum serum HBV who took telbivudine during pregnancy or not and the different withdraw times after delivery.

Methods

Total of 626 HBeAg positive pregnant patients with high viral load of HBV DNA were collected in Beijing Ditan Hospital, Capital Medical University from January 2012 to December 2013. They were divided into two groups: telbivudine treatment group (LdT group, 267 cases) and without antiviral drug group (control group, 359 cases). The levels of serum HBV DNA and the change of liver function were analyzed between women who took telbivudine during pregnancy or not and the different withdraw times after delivery.

Results

The HBV DNA levels in LdT group significantly decreased than that of control group (t = 55.2413, P = 0.0000). The amount of pregnant women with HBV DNA < 500 copies/ml in LdT group was more than those in the control group (χ² = 49.5180, P = 0.0000). There was no significant difference between the two groups at liver function in the first 6 months after delivery (Z =-0.021, P = 0.9836). The cases with ALT > 2 × ULN of postpartum in control group were more than those in the LdT group (χ² = 9.1562, P = 0.002). The levels of ALT were higher in women who suspended telbivudine 0-29 days after delivery than those suspended telbivudine more than 30 days after delivery. The number of postpartum women with > 2 × ULN in women who suspended telbivudine 0-29 days after delivery were more than the postpartum women who suspended telbivudine for more than 30 days.

Conclusions

Telbivudine presents an enhanced effect of preventing mother-infant transmission of hepatitis B virus infection during the third pregnancy stage. With the decreasing of HBV DNA level, telbivudine would not attribute to the risk of ALT increasing, while the withdraw in the early stage might relate to higher ALT level.

Key words: Telbivudine, Pregnancy, Hepatitis B virus, Liver function

Qianying Zhuang, Min Liu, Dong Fu, Xiaoyan Ma, Haodong Cai. The postpartum changes of liver function after telbivudine treatment in preventing mother-to-child transmission of hepatitis B virus infection during pregnancy[J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2016, 10(03): 337-341.

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组别	例数	年龄（±s，岁）	产次（经产/初产，例）	不良孕史[例（%）]	妊娠第1期
组别	例数	年龄（±s，岁）	产次（经产/初产，例）	不良孕史[例（%）]	HBV DNA（±s，log₁₀拷贝/ml）	ALT（±s，U/L）
LdT组	267	27.7 ± 3.45	32/235	27 （10.1）	7.44 ± 0.03	41.6 ± 7.09
对照组	359	28.3 ± 3.93	54/305	33 （9.2）	7.34 ± 0.03	38.4 ± 4.54
统计量		t = 1.7776	χ² = 1.2073	χ² = 0.1496	t = 2.2097	t = 0.3828
P值		0.0760	0.2720	0.6990	0.0275	0.7020

组别	例数	年龄（±s，岁）	产次（经产/初产，例）	不良孕史[例（%）]	妊娠第1期
组别	例数	年龄（±s，岁）	产次（经产/初产，例）	不良孕史[例（%）]	HBV DNA（±s，log₁₀拷贝/ml）	ALT（±s，U/L）
LdT组	267	27.7 ± 3.45	32/235	27 （10.1）	7.44 ± 0.03	41.6 ± 7.09
对照组	359	28.3 ± 3.93	54/305	33 （9.2）	7.34 ± 0.03	38.4 ± 4.54
统计量		t = 1.7776	χ² = 1.2073	χ² = 0.1496	t = 2.2097	t = 0.3828
P值		0.0760	0.2720	0.6990	0.0275	0.7020

组别	例数	HBV DNA载量（±s，log₁₀拷贝/ml）	HBV DNA低于检测下限[例（%）]
LdT组	267	3.74 ± 0.82	37（13.9）
对照组	359	7.29 ± 0.78	1（0.3）
统计量		t = 55.2413	χ² = 49.5180
P值		0.0000	0.0000

组别	例数	HBV DNA载量（±s，log₁₀拷贝/ml）	HBV DNA低于检测下限[例（%）]
LdT组	267	3.74 ± 0.82	37（13.9）
对照组	359	7.29 ± 0.78	1（0.3）
统计量		t = 55.2413	χ² = 49.5180
P值		0.0000	0.0000

组别	例数	ALT
组别	例数	中位数（U/L）	范围（U/L）	> 2 × ULN [例（%）]
LdT组	267	45.5	14.2～729.9	78（29.4）
对照组	359	47.6	12.5～1043.8	147（40.9）
统计量		Z = 0.0210		χ² = 9.1562
P值		0.9836		0.0020

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