妊娠中晚期口服替诺福韦酯阻断HBV垂直传播的有效性及安全性

目的探讨感染HBV的妊娠中晚期孕妇口服替诺福韦酯（TDF）阻断HBV母婴垂直传播的有效性及安全性。 方法从已拒绝终止妊娠及接受TDF抗病毒治疗的孕妇中纳入研究对象共计100例，包括分别于妊娠第20周、第24周、第28周、第32周及第36周开始接受TDF抗病毒治疗的5个治疗组的孕妇各20例；从拒绝接受TDF抗病毒治疗的感染HBV的孕妇中纳入20例设为对照组。 结果治疗组孕妇分娩前HBV DNA水平显著低于对照组，差异具有统计学意义（t =－8.737、P < 0.001）。治疗组孕妇分娩前HBV DNA水平在孕24周和28周差异无统计学意义（t =－0.911、P = 0.368）。治疗组胎儿出生后48周检测HBsAg、HBV DNA阳性率均为0%。治疗组孕妇均未出现明显的药物不良反应，其所产婴幼儿均无出生缺陷及相关并发症。 结论孕28周前口服TDF抗病毒治疗能够有效且安全地阻断HBV的母婴垂直传播。

Efficacy and safety on blocking HBV vertical transmission by oral tenofovir disoproxil treatment in middle-late pregnancy

ObjectiveTo investigate the efficacy and safety of oral tenofovir disoproxil (TDF) in pregnant women with HBV infection. MethodsTotal of 100 cases were collected from pregnant women who had refused termination of pregnancy and received TDF antivirus treatment, including 20 cases in each of the five treatment groups who started to receive TDF antivirus treatment at the 20th, 24th, 28th, 32nd and 36th weeks of pregnancy, respectively. A control group of 20 patients with HBV infection were included from pregnant women who refused TDF antiviral treatment. ResultsThe level of HBV DNA in the treatment group was significantly lower thanthat in the control group (t =-8.737, P < 0.001). There was no significant difference in HBV DNA levels at the 24 th and 28th weeks before delivery (t =-0.911, P = 0.368). The positive rate of HBsAg and HBV DNA was 0% in 48 weeks after birth. No adverse drug reactions were found in pregnant women in the treatment group, and there were no birth defects and related complications. ConclusionsOral TDF antiviral therapy before 28 weeks of pregnancy could effectively and safely block the vertical transmission of HBV.