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NEJM:替诺福韦降低HBV母婴传播风险

2018-03-08 zhangfan MedSci原创

研究认为,对于HBeAg阳性孕妇,在注射HBV免疫球蛋白以及疫苗的基础上服用替诺福韦可进一步的降低新生儿HBV母婴传播风险

即使接种了HBV免疫球蛋白,孕妇HBV病毒当量过高仍会导致新生儿HBV感染

近日研究人员在泰国开展研究,招募丙氨酸转氨酶浓度60 IU 以下且HBeAg阳性孕妇,患者在孕28周到产后2个月内,随机接受富马酸替诺福韦酯(TDF)或安慰剂。新生儿在出生时接种乙肝免疫球蛋白,在出生后1、2、4、6个月接种乙肝疫苗,考察组间新生儿HBV感染风险差异。

331名孕妇参与研究,其中TDF组168人,安慰剂组163人。孕妇平均孕龄28.3周,HBV DNA水平为8.0 log10 IU/mL。总计322名新生儿,其中单胎319人,2对双胞胎,1名产死。新生儿出生到免疫蛋白注射时间为1.3小时,到HBV疫苗注射时间为1.2小时。研究发现,147名TDF组新生儿,无HBV感染,而147名安慰剂组新生儿中3人HBV感染。组间不良事件发生率差异不显著。TDF组停药后丙氨酸氨基转移酶水平超过300单位的发生率为6%,安慰剂组为3%。

研究认为,对于HBeAg阳性孕妇,在注射HBV免疫球蛋白以及疫苗的基础上服用替诺福韦可进一步的降低新生儿HBV母婴传播风险。

原始出处:

Gonzague Jourdain et al. Tenofovir versus Placebo to Prevent Perinatal Transmission of Hepatitis B. N Engl J Med. March 8, 2018.

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    2018-12-02 klivis
  2. [GetPortalCommentsPageByObjectIdResponse(id=1836653, encodeId=81a11836653e7, content=<a href='/topic/show?id=f9d08524be' target=_blank style='color:#2F92EE;'>#HBV#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8524, encryptionId=f9d08524be, topicName=HBV)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e87531, createdName=klivis, createdTime=Sun Dec 02 13:10:00 CST 2018, time=2018-12-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=306236, encodeId=72f43062365e, content=原文不是说没有统计学差异么, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b9dc2268622, createdName=1219cf7cm92暂无昵称, createdTime=Mon Apr 16 06:48:20 CST 2018, time=2018-04-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1428630, encodeId=2b37142863022, content=<a href='/topic/show?id=9a0f60359a7' target=_blank style='color:#2F92EE;'>#替诺福韦#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=60359, encryptionId=9a0f60359a7, topicName=替诺福韦)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=be144108328, createdName=yhj-time, createdTime=Sat Mar 10 01:10:00 CST 2018, time=2018-03-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1439373, encodeId=bc2614393e30f, content=<a href='/topic/show?id=45616352128' target=_blank style='color:#2F92EE;'>#母婴#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63521, encryptionId=45616352128, topicName=母婴)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Sat Mar 10 01:10:00 CST 2018, time=2018-03-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=294212, encodeId=f4992942128d, content=样本量更多些就好了, beContent=null, objectType=article, channel=null, level=null, likeNumber=146, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKibA62IFMeUJEmSyIe8DvYFeERuOsfrRd8iano7nENqQU1dRR3tqeQOUL3eqgYgEZRT2t2iaEsib0JEw/132, createdBy=66771693911, createdName=易水河, createdTime=Thu Mar 08 15:49:04 CST 2018, time=2018-03-08, status=1, ipAttribution=)]
    2018-04-16 1219cf7cm92暂无昵称

    原文不是说没有统计学差异么

    0

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    2018-03-10 zhouqu_8
  5. [GetPortalCommentsPageByObjectIdResponse(id=1836653, encodeId=81a11836653e7, content=<a href='/topic/show?id=f9d08524be' target=_blank style='color:#2F92EE;'>#HBV#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8524, encryptionId=f9d08524be, topicName=HBV)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e87531, createdName=klivis, createdTime=Sun Dec 02 13:10:00 CST 2018, time=2018-12-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=306236, encodeId=72f43062365e, content=原文不是说没有统计学差异么, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b9dc2268622, createdName=1219cf7cm92暂无昵称, createdTime=Mon Apr 16 06:48:20 CST 2018, time=2018-04-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1428630, encodeId=2b37142863022, content=<a href='/topic/show?id=9a0f60359a7' target=_blank style='color:#2F92EE;'>#替诺福韦#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=60359, encryptionId=9a0f60359a7, topicName=替诺福韦)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=be144108328, createdName=yhj-time, createdTime=Sat Mar 10 01:10:00 CST 2018, time=2018-03-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1439373, encodeId=bc2614393e30f, content=<a href='/topic/show?id=45616352128' target=_blank style='color:#2F92EE;'>#母婴#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63521, encryptionId=45616352128, topicName=母婴)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Sat Mar 10 01:10:00 CST 2018, time=2018-03-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=294212, encodeId=f4992942128d, content=样本量更多些就好了, beContent=null, objectType=article, channel=null, level=null, likeNumber=146, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKibA62IFMeUJEmSyIe8DvYFeERuOsfrRd8iano7nENqQU1dRR3tqeQOUL3eqgYgEZRT2t2iaEsib0JEw/132, createdBy=66771693911, createdName=易水河, createdTime=Thu Mar 08 15:49:04 CST 2018, time=2018-03-08, status=1, ipAttribution=)]
    2018-03-08 易水河

    样本量更多些就好了

    0

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