Analysis of long-term safety and efficacy of nucleos(t)ide analogue therapy for chronic hepatitis B throughout pregnancy. (April 2021)

• Record Type: Journal Article
• Authors: Shang, Jin; Liu, Huan; Wen, Qin; M ise, Rili; Tu, You; Bai, Lang; Tang, Hong
• Is Part Of: International journal of infectious diseases. Volume 105(2021)
• Page Start: 626
• Page End: 631
• Publication Date: 2021-04
• Subjects: Hepatitis B virus -- Pregnancy -- Telbivudine -- Tenofovir -- Nucleos(t)ide analogue; Communicable diseases -- Periodicals; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; Electronic journals; 616.9
• DOI: 10.1016/j.ijid.2021.03.023
• Languages: English
• ISSNs: 1201-9712

Abstract

Highlights: Limited data exist on the long-term safe of nucleos(t)ide analogue therapy throughout pregnancy. Safety of telbivudine (LDT) and tenofovir (TDF) in women and their children were evaluated. TDF treatment throughout pregnancy showed better long-term efficacy than LDT treatment. TDF and LDT both showed no evidence of renal toxicity during pregnancy and postpartum in women. The use of TDF and LDT throughout pregnancy had no effect on long-term development of children. Abstract: Background: Limited data exist regarding the efficacy and long-term safety of nucleos(t)ide analogue therapy throughout pregnancy for women with chronic hepatitis B and their children. Methods: This retrospective cohort study included 165 women in total: 91 women received telbivudine (LDT) and 74 women received tenofovir (TDF) throughout pregnancy. The virological response and safety in women were recorded, and the physical development and bone mineral density in children were evaluated up to 5 years of age. Results: The rate of virological breakthrough in women was 4.24% overall (7.70% in LDT group and 0% in TDF group; P < 0.05). No cases of renal injury or other obstetric adverse events occurred in either group of women. Among the children, only one child had a significantly low Z score for weight for age (<-2), and no children had a significantly low Z score for height for age or bone mineral density. No significant difference was found between the children in the two groups. Conclusions: Nucleos(t)ide analogue therapy with TDF or LDT throughout pregnancy had no effect on the long-term physical development and bone development of children. In addition, the use of TDF throughout pregnancy had better long-term antiviral efficacy than LDT in women, with no evidence of renal toxicity.