| Objective:To systematically review the efficacy and safety of telbivudine in pr eventing mother-to-infant transmission of hepatitis B virus in the third trimester of pregnancy.Methods:Chinese Biomedical Literature Database,WanFang Database Onli ne,Chinese Scientific Journals Database,CNKI,PubMed,ISI web of knowledge,EMbas e,Cochrane Library and BIOSIS Previews were searched for related articles till Dec ember2013.Two reviewers independently screened these articles according to inclus ion and exclusion criterion.Meta-analysis was performed by using software Rvman5.1.Results:Twelve papers were included in this study, with a total of1301pregna nt women,including632cases received telbivudine and669cases of control;Meta-a nalysis showed that,after a6to12month of follow-up,the seropositive rates for H BsAg and HBV DNA in babies of telbivudine-treated mothers were significantly lo wer than in babies of non-treated mothers[RR=0.15,95%CI(0.08,0.27),P<0.00001;RR=0.12,95%CI(0.05,0.32),P<0.0001],the seropositive rates for Anti-HBs in babies of telbivudine-treated mothers were significantly higher than in babies of non-treated mothers[RR=1.27,95%CI(1.09,1.47),P=0.002].Maternal HBV DNA and ALT levels pr ior to delivery was significantly lower in telbivudine-treated women than in non-tre ated women[MD=-3.77,95%CI(-4.38,-3.15),P<0.00001;MD=-17.71,95%CI(-24.51,-10.91),P<0.00001];The rate of elevation in serum creatine kinase was significantly hig her in telbivudine-treated mothers than in non-treated mothers[MD=-3.86,95%CI(-4.55,-3.16),P<0.00001];The neonates in telbivudine group were born without deformity and other complications.Conclusion:Telbivudine is effective and safe in blocking HBV intrauterine infection to some extent.However,it is a bit less persuasive becau se of the low quality of included studies and the methodological quality of include d studied was generally low.Therefore,the prospective,high-quailty,large sample and multicentre randomized controlled trial was needed. |
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