对慢性 HBV 感染妇女产后复发进行抗病毒治疗可缩短谷丙转氨酶恢复时间并降低 4 年内肝炎复发率。

IF 2.7 4区 医学 Q2 Medicine
Canadian Journal of Gastroenterology and Hepatology Pub Date : 2022-06-20 eCollection Date: 2022-01-01 DOI:10.1155/2022/4753267
Min Quan, Cong Liu, Wei Li, Hui-Chun Xing
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引用次数: 0

摘要

背景:目的:本研究旨在分析抗HBV治疗对产后肝炎复发的影响,并评估产后4年内的预后情况:这项回顾性研究纳入了乙型肝炎表面抗原(HBsAg)阳性和乙型肝炎e抗原(HBeAg)阳性、HBV DNA≥106 IU/mL的孕妇。共纳入 152 名孕妇:预防性抗 HBV 治疗组(PT-G)103 人,非预防性抗 HBV 治疗组(NPT-G)49 人。产后复发的妇女被分配到抗 HBV 治疗组(AT-G)和非抗 HBV 治疗组(NAT-G),以分析产后抗 HBV 治疗对肝炎复发的影响。对病毒学和生化指标进行了评估:以产后 12 周为分界点,AT-G 组(n = 16,42.1%)或 PT-G 组(n = 23,34.8%)产后复发妇女的 ALT 恢复时间短于 NAT-G 组(n = 14,23.0%;x 2 = 4.067,P=0.044)或 NPT-G 组(n = 4,11.1%;x 2 = 5.579,P=0.018)。以产后 26 周为分界点,AT-G(35 人,57.3%)或 PT-G(44 人,66.7%)的 ALT 恢复时间短于 NAT-G(32 人,84.2%;x 2 = 7.707,P=0.006)或 NPT-G(16 人,44.4%;x 2 = 4.749,P=0.029)。产后复发时间与分娩时的 HBV DNA 水平呈正相关[r = 0.223,P=0.025,95%CI (0.022~0.41)]。AT-G 在产后 4 年内的肝炎复发率(n = 3,9.68%)低于 NAT-G(n = 24,45.4%;x 2 = 14.003,P ≤ 0.001)。AT-G产后4年的HBeAg、HBsAg、HBV DNA和ALT水平均低于NAT-G(P < 0.001):结论:对产后肝炎复发的慢性 HBV 妇女进行抗 HBV 治疗可缩短 ALT 恢复时间,降低产后 4 年内肝炎复发率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Antiviral Therapy for a Postpartum Flare in Women with Chronic HBV Infection Shortens the ALT Recovery Time and Reduces Hepatitis Re-Flare Rates within 4 years.

Antiviral Therapy for a Postpartum Flare in Women with Chronic HBV Infection Shortens the ALT Recovery Time and Reduces Hepatitis Re-Flare Rates within 4 years.

Antiviral Therapy for a Postpartum Flare in Women with Chronic HBV Infection Shortens the ALT Recovery Time and Reduces Hepatitis Re-Flare Rates within 4 years.

Antiviral Therapy for a Postpartum Flare in Women with Chronic HBV Infection Shortens the ALT Recovery Time and Reduces Hepatitis Re-Flare Rates within 4 years.

Background: Few studies explored whether anti-hepatitis B virus (HBV) therapy should be initiated during postpartum hepatitis flare.

Aim: This study aimed to analyze the effect of anti-HBV therapy on postpartum hepatitis flare and evaluate the prognosis within 4 years postpartum.

Methods: This retrospective study enrolled hepatitis B surface antigen (HBsAg)-positive and hepatitis B e antigen (HBeAg)-positive pregnant women with HBV DNA ≥ 106 IU/mL. A total of 152 pregnant women were included: 103 in the prophylactic anti-HBV therapy group (PT-G) and 49 in the non-prophylactic anti-HBV therapy group (NPT-G). The women with a postpartum flare were assigned to the anti-HBV therapy group (AT-G) and non-anti-HBV therapy group (NAT-G) to analyze the effect of postpartum anti-HBV therapy on hepatitis flare. Virological and biochemical parameters were assessed.

Results: Taking postpartum 12 weeks as the cutoff point, the ALT recovered time for postpartum flare women is shorter in AT-G (n = 16, 42.1%) or PT-G (n = 23, 34.8%) than in NAT-G (n = 14, 23.0%; x 2 = 4.067, P=0.044) or NPT-G (n = 4, 11.1%; x 2 = 5.579, P=0.018). Taking postpartum 26 weeks as the cutoff point, the ALT recovered time is shorter in AT-G (n = 35, 57.3%) or PT-G (n = 44, 66.7%) than in NAT-G (n = 32, 84.2%; x 2 = 7.707, P=0.006) or NPT-G (n = 16, 44.4%; x 2 = 4.749, P=0.029). Postpartum flare recovery time was positively correlated with HBV DNA level at delivery [r = 0.223, P=0.025, 95%CI (0.022~0.41)]. The hepatitis re-flare rates within postpartum 4 years in AT-G (n = 3, 9.68%) is lower than that in NAT-G (n = 24, 45.4%; x 2 = 14.003, P ≤ 0.001). The HBeAg, HBsAg, HBV DNA, and ALT level at postpartum 4 years in AT-G were lower than that in NAT-G (P < 0.001).

Conclusion: Anti-HBV therapy for postpartum hepatitis flare of women with chronic HBV could shorten the ALT recovery time and reduce hepatitis re-flare rates within 4 years of postpartum.

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来源期刊
CiteScore
4.80
自引率
0.00%
发文量
0
审稿时长
37 weeks
期刊介绍: Canadian Journal of Gastroenterology and Hepatology is a peer-reviewed, open access journal that publishes original research articles, review articles, and clinical studies in all areas of gastroenterology and liver disease - medicine and surgery. The Canadian Journal of Gastroenterology and Hepatology is sponsored by the Canadian Association of Gastroenterology and the Canadian Association for the Study of the Liver.
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