Premium
Efficacy and safety of antiviral treatment on blocking the mother‐to‐child transmission of hepatitis B virus: A meta‐analysis
Author(s) -
Song Jiahui,
Yang Fan,
Wang Shuo,
Tikande Sakinatou,
Deng Yang,
Tang Weina,
Cao Guangwen
Publication year - 2019
Publication title -
journal of viral hepatitis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.329
H-Index - 100
eISSN - 1365-2893
pISSN - 1352-0504
DOI - 10.1111/jvh.13036
Subject(s) - telbivudine , medicine , hbsag , lamivudine , hepatitis b virus , relative risk , hepatitis b , transmission (telecommunications) , pregnancy , confidence interval , meta analysis , obstetrics , virology , virus , biology , electrical engineering , genetics , engineering
Summary Nucleo(t)side analogues ( NA s) 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 NA s treatment during pregnancy. The differences among different agents and initiation trimesters were analysed. A total of 9228 mother‐infant pairs in 59 studies (32 RCT s and 27 non‐ RCT s) were included in this meta‐analysis. NA s significantly reduced the risk of MTCT , as indicated by seropositivity of hepatitis B surface antigen ( HBsA g) (risk ratio ( RR ) = 0.51, 95% confidence interval ( CI ) 0.45‐0.57) and HBV DNA in newborns ( RR = 0.22, 95% CI 0.18‐0.26). 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 HBsA g ( 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.