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Abstract Details
Efficacy and safety of antiviral treatment on blocking the mother-to-child transmission of hepatitis B virus: a meta-analysis
Song J1, Yang F1, Wang S1, Tikande S1, Deng Y1, Tang W1, Cao G1. J Viral Hepat. 2018 Nov 11. doi: 10.1111/jvh.13036. [Epub ahead of print]
Author information
1
Department of Epidemiology, Second Military Medical University, Shanghai, 200433, China.
Abstract
Nucleo(t)side analogues (NAs) have been administered as adjunctive therapy to interrupt the mother-to-child transmission (MTCT) of hepatitis B virus (HBV). The efficacy and safety of this method remain controversial. A Meta-analysis was conducted to evaluate the efficacy and safety of NAs treatment during pregnancy. The differences among different agents and initiation trimesters were analysed. A total of 9228 mother-infant-pairs in 59 studies (32 RCTs and 27 non-RCTs) were included in this meta-analysis. NAs significantly reduced the risk of MTCT, as indicated by seropositivity of hepatitis B surface antigen (HBsAg) (risk ratio (RR)=0.51, 95% confidence interval (CI) 0.45 to 0.57) and HBV DNA in newborns (RR=0.22, 95% CI 0.18 to 0.26). No differences in the efficacy of interrupting HBV MTCT were evident among lamivudine, telbivudine, and tenofovir disoproxil fumarate. NA was more effective when administered from the second than from the third trimester as indicated by HBV DNA (RR: the second vs. the third 0.08 vs. 0.22, P=0.010), but this effect was not evident as indicated by HBsAg (RR: the second vs. the third 0.46 vs. 0.53, P=0.596). Antiviral treatment initiated from the second trimester did not confer a higher risk of safety problems in the newborns compared with treatment from the third trimester, as indicated by weight (P=0.064), length (P=0.491), and malformation rate (P=0.635) of newborns. CONCLUSIONS: Lamivudine, telbivudine, and tenofovir disoproxil fumarate are equally effective in blocking HBV MTCT. Antiviral treatment can be applied from the second trimester, without obvious safety concerns.