The Clinical Analysis Of Tenofovir In The Second Trimester To Prevent Mother To Child Transmission Of Hepatitis B Virus

Objective:To evaluate the efficacy and safety of tenofovir use in the second trimester in reducing HBV transmission in HBV-infected womenMethods:(1)HBsAg+mothers were selected for retrospective statistical analysis,according to whether to take tenofovir between weeks 24-28 of gestation with HBeAg+and HBV-DNA>2.0E+06 IU/mL divided into tenofovir group and no tenofovir group.Tenofovir group to be pregnant for 24-28 weeks took tenofovir 300mg/d until week 4 postpartum.Regularly follow-up of HBeAg and HBV-DNA,the change of liver function,and at the same time we record every follow-up of adverse events.(2)A11 infants immediately drew blood for test HBV-M and HBV-DNA after birth and received active-passive immunization(200IU of HBIG at O and 1 month and hepatitis B vaccine of 10ug at 0,1 and 6 month).Regularly followed up to 7 month,recording the infant’s general condition(body length,body weight,head circumference),adverse events,and the result of HBV-M.Results:(1)Enrolled high viral load of HBV infection in pregnant women delivered in Shanghai Public Health Clinical Center from January 2016 to December 2017:86 in tenofovir groupand 106 in control group.Maternal baselines about HBeAg、HBV-DNA and ALT levels were similar(P>0.05).Prior to delivery,maternal HBV-DNA levels were(3.82±0.80)logioIU/mL in tenofovir group lower than in control group(P=0.000).At week 28,0%of the infants from tenofovir treated mothers were HBsAg+and HBV-DNA+compared with 2.8%in the control group(P=0.130).(2)follow-up to week 28 postpartum,no significant difference between two groups of mothers during pregnancy、intrapartum and postpartum associated comorbidities and complications,mode of delivery(P>0.05).All mothers discontinued tenofovir at week 4 postpartum,and followed up to week 28 postpartum no case of severe liver damage Occurs.The control abnormal rate of ALT is higher than tenofovir group,compared two groups have no significant difference(P>0.05).(3)The tenofovir group and the control group all had no incidence of congenital malformations,no difference for gestational age,height,weight,head circumference were found between both groups.No significant difference for each time period of growth and development indexes(height,weight,head circumference)were found between both groups.There was no significant difference in the adverse event of infants in the two groups.Conclusions:(1)Tenofovir used in second trimester in HBeAg+highly viremic mothers can safely reduced perinatal HBV transmission.(2)Tenofovir is well-tolerated with no concerns in the tenofovir-treated mothers and their infants on short term follow up.