替比夫定和替诺福韦阻断乙型肝炎病毒母婴传播的疗效和安全性meta分析

肝脏 ›› 2021, Vol. 26 ›› Issue (1): 22-26.

替比夫定和替诺福韦阻断乙型肝炎病毒母婴传播的疗效和安全性meta分析

邓勇, 郭丽霞, 李朝亮, 曾桃, 陶学萍, 黄水根, 欧书强

337000 江西萍乡市第二人民医院感染科(邓勇,李朝亮,曾桃,陶学萍,黄水根,欧书强);萍乡市人民医院病理科(郭丽霞)

收稿日期:2020-01-13 出版日期:2021-01-31 发布日期:2021-02-26
基金资助:
江西省卫建委科技计划项目(20204435)

A meta-analysis for the efficacy and safety of telbivudine and tenofovir in preventing mother-to-child transmission of hepatitis B virus

DENG Yong, GUO Xia-li, LI Zhao-liang, ZENG Tao, TAO Xue-ping, HUANG Shui-gen, OU Shu-qiang

Department of Infectious Diseases, the second People's Hospital in Pingxiang, Jiangxi 337000, China

Received:2020-01-13 Online:2021-01-31 Published:2021-02-26

摘要/Abstract

摘要： 目的评价HBV DNA阳性孕妇在妊娠中晚期应用替比夫定(LDT)和替诺福韦(TDF)进行母婴阻断的疗效和安全性是否存在差异。方法在数据库CNKI、万方、维普、Pumed、CBM中检索发表于2010年1月至2019年8月的论文,收集我国学者发表的慢性HBV携带者孕妇在妊娠中晚期比较应用LDT和TDF阻断HBV母婴传播疗效的研究,采用Rev Man 5.0软件进行meta分析。结果共纳入RCT研究1篇,队列研究9篇,替比夫定组纳入孕妇897例,替诺福韦组纳入孕妇716例,新生儿出生时HBsAg阳性例数分别为11例和2例,OR=1.66,95%CI(0.76,3.62),P=0.21,新生儿出生时体重无差异OR=17.83,95%CI(-39.47,75.14), P=0.54,新生儿畸形例数分别为6例(0.67%)和1例(0.14%)。结论高载量HBV DNA慢性HBV携带者孕妇在妊娠中晚期使用LDT或TDF均能明显降低母婴传播风险,两者的母婴阻断率、不良事件发生率及胎儿畸形率均无明显差异,均安全可靠。

关键词: 替比夫定, 替诺福韦, 母婴阻断, meta分析

Abstract: Objective To evaluate the treatment efficacy and safety of telbivudine (LDT) and tenofovir (TDF) for preventing mother-to child transmission in HBV DNA-positive pregnant women at their middle and late stages of pregnancy.Methods The literatures published by Chinese scholars from January 2010 to August 2019 on the comparative application of LDT and TDF to prevent HBV mother-to-child transmission in pregnant women at the middle and late stages of pregnancy were retrieved from CNKI, Wan Fang, Weipu, Pubmed, and CBM. meta analysis was performed on these studies using Rev. Man 5.0 software.Results One randomized control trial (RCT) and 9 cohort studies were recruited, with a total of 897 and 716 cases of pregnant women in LDT group and TDF group, respectively. The numbers of HBsAg positive cases at birth in these two groups were 11 and 2, respectively [OR=1.66, 95 % CI(0.76, 3.62), P=0.21]. There were no significant differences in the neonatal birth weight [OR=17.83, 95 % CI(-39.47±75.14), P=0.54], and the numbers of neonatal malformation [6(0.67 %) vs 1(0.14 %)].Conclusion Both LDT and TDF treatments for the middle and late stages of pregnant women with high HBV DNA load reduce the risk of mother-to-child transmission of HBV effectively and safely.

Key words: Telbivudine, Tenofovir, Blocking mother-to-child transmission, meta-analysis

邓勇, 郭丽霞, 李朝亮, 曾桃, 陶学萍, 黄水根, 欧书强. 替比夫定和替诺福韦阻断乙型肝炎病毒母婴传播的疗效和安全性meta分析[J]. 肝脏, 2021, 26(1): 22-26.

DENG Yong, GUO Xia-li, LI Zhao-liang, ZENG Tao, TAO Xue-ping, HUANG Shui-gen, OU Shu-qiang. A meta-analysis for the efficacy and safety of telbivudine and tenofovir in preventing mother-to-child transmission of hepatitis B virus[J]. Chinese Hepatolgy, 2021, 26(1): 22-26.

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