Early Start Of Tenofovir Treatment Achieves Better Viral Suppression In Pregnant Women With A High HBV Viral Load: A Real-World Prospective Study
Fan Gao,1 Wen-Tao Zhang,2 Ya-Yun Lin,2 Wei-Min Wang,2 Na Xu,2 Gui-Qin Bai2 1Clinical Research Center, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi 710061, People’s Republic of China; 2Department of Gynecology and Obstetrics, The First Affil...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2019-11-01
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| Series: | Infection and Drug Resistance |
| Subjects: | |
| Online Access: | https://www.dovepress.com/early-start-of-tenofovir-treatment-achieves-better-viral-suppression-i-peer-reviewed-article-IDR |
| _version_ | 1828305420251299840 |
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| author | Gao F Zhang WT Lin YY Wang WM Xu N Bai GQ |
| author_facet | Gao F Zhang WT Lin YY Wang WM Xu N Bai GQ |
| author_sort | Gao F |
| collection | DOAJ |
| description | Fan Gao,1 Wen-Tao Zhang,2 Ya-Yun Lin,2 Wei-Min Wang,2 Na Xu,2 Gui-Qin Bai2 1Clinical Research Center, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi 710061, People’s Republic of China; 2Department of Gynecology and Obstetrics, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi 710061, People’s Republic of ChinaCorrespondence: Gui-Qin BaiDepartment of Gynecology and Obstetrics, The First Affiliated Hospital of Xi’an Jiaotong University, 277 Yanta West Road, Xi’an, Shaanxi 710061, People’s Republic of ChinaTel +86-18991232517Email baigq@126.comPurpose: To investigate whether tenofovir disoproxil fumarate (TDF) treatment that started from the second trimester had an advantage over TDF treatment that started from the third trimester.Patients and methods: Twenty 35-year-old pregnant women with hepatitis B virus (HBV) DNA >2×106 IU/mL were prospectively enrolled in this study. All participants were divided into two subgroups: the second trimester group who started TDF treatment at 24–27 weeks and the third trimester group who started TDF treatment at 28–30 weeks. The primary outcome was the change in serum HBV DNA level from baseline to delivery. Each parameter was tested every 4 weeks from TDF initiation to 3 months postpartum.Results: There were 80 pregnant women in the second trimester group and 49 pregnant women in the third trimester group. The decline in HBV DNA from baseline to delivery was more obvious in the second trimester group (4.8±1.2 log10 IU/mL) than that in the third trimester group (4.3±1.1 log10 IU/mL, p=0.041). The downward shift of haemoglobin (HB) from baseline to delivery was greater in the second trimester group (10.6±10.7 g/L) than in the third trimester group (6.3±12.3 g/L, p=0.041). The decline in HBV DNA from baseline to delivery was linearly related to the start of TDF treatment from the second trimester (β=0.50 and 95% CI: 0.26–0.75, p<0.001). There were no significant differences between the two groups regarding HBV serologic markers and safety indicators.Conclusion: Starting TDF treatment from the second trimester achieved better viral suppression than starting TDF treatment from the third trimester in highly viraemic pregnant women without increasing additional adverse reactions. HB level needed frequent monitoring during treatment to avoid anaemia.Registry number: Clinical Trial No. NCT02719808.Keywords: tenofovir disoproxil fumarate, efficacy, safety, second trimester, third trimester
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| first_indexed | 2024-04-13T14:28:18Z |
| format | Article |
| id | doaj.art-31aff5159bbb4d7e9c93448699f50164 |
| institution | Directory Open Access Journal |
| issn | 1178-6973 |
| language | English |
| last_indexed | 2024-04-13T14:28:18Z |
| publishDate | 2019-11-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Infection and Drug Resistance |
| spelling | doaj.art-31aff5159bbb4d7e9c93448699f501642022-12-22T02:43:15ZengDove Medical PressInfection and Drug Resistance1178-69732019-11-01Volume 123475348449622Early Start Of Tenofovir Treatment Achieves Better Viral Suppression In Pregnant Women With A High HBV Viral Load: A Real-World Prospective StudyGao FZhang WTLin YYWang WMXu NBai GQFan Gao,1 Wen-Tao Zhang,2 Ya-Yun Lin,2 Wei-Min Wang,2 Na Xu,2 Gui-Qin Bai2 1Clinical Research Center, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi 710061, People’s Republic of China; 2Department of Gynecology and Obstetrics, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi 710061, People’s Republic of ChinaCorrespondence: Gui-Qin BaiDepartment of Gynecology and Obstetrics, The First Affiliated Hospital of Xi’an Jiaotong University, 277 Yanta West Road, Xi’an, Shaanxi 710061, People’s Republic of ChinaTel +86-18991232517Email baigq@126.comPurpose: To investigate whether tenofovir disoproxil fumarate (TDF) treatment that started from the second trimester had an advantage over TDF treatment that started from the third trimester.Patients and methods: Twenty 35-year-old pregnant women with hepatitis B virus (HBV) DNA >2×106 IU/mL were prospectively enrolled in this study. All participants were divided into two subgroups: the second trimester group who started TDF treatment at 24–27 weeks and the third trimester group who started TDF treatment at 28–30 weeks. The primary outcome was the change in serum HBV DNA level from baseline to delivery. Each parameter was tested every 4 weeks from TDF initiation to 3 months postpartum.Results: There were 80 pregnant women in the second trimester group and 49 pregnant women in the third trimester group. The decline in HBV DNA from baseline to delivery was more obvious in the second trimester group (4.8±1.2 log10 IU/mL) than that in the third trimester group (4.3±1.1 log10 IU/mL, p=0.041). The downward shift of haemoglobin (HB) from baseline to delivery was greater in the second trimester group (10.6±10.7 g/L) than in the third trimester group (6.3±12.3 g/L, p=0.041). The decline in HBV DNA from baseline to delivery was linearly related to the start of TDF treatment from the second trimester (β=0.50 and 95% CI: 0.26–0.75, p<0.001). There were no significant differences between the two groups regarding HBV serologic markers and safety indicators.Conclusion: Starting TDF treatment from the second trimester achieved better viral suppression than starting TDF treatment from the third trimester in highly viraemic pregnant women without increasing additional adverse reactions. HB level needed frequent monitoring during treatment to avoid anaemia.Registry number: Clinical Trial No. NCT02719808.Keywords: tenofovir disoproxil fumarate, efficacy, safety, second trimester, third trimester https://www.dovepress.com/early-start-of-tenofovir-treatment-achieves-better-viral-suppression-i-peer-reviewed-article-IDRtenofovir disoproxil fumarateefficacysafetysecond trimesterthird trimester |
| spellingShingle | Gao F Zhang WT Lin YY Wang WM Xu N Bai GQ Early Start Of Tenofovir Treatment Achieves Better Viral Suppression In Pregnant Women With A High HBV Viral Load: A Real-World Prospective Study Infection and Drug Resistance tenofovir disoproxil fumarate efficacy safety second trimester third trimester |
| title | Early Start Of Tenofovir Treatment Achieves Better Viral Suppression In Pregnant Women With A High HBV Viral Load: A Real-World Prospective Study |
| title_full | Early Start Of Tenofovir Treatment Achieves Better Viral Suppression In Pregnant Women With A High HBV Viral Load: A Real-World Prospective Study |
| title_fullStr | Early Start Of Tenofovir Treatment Achieves Better Viral Suppression In Pregnant Women With A High HBV Viral Load: A Real-World Prospective Study |
| title_full_unstemmed | Early Start Of Tenofovir Treatment Achieves Better Viral Suppression In Pregnant Women With A High HBV Viral Load: A Real-World Prospective Study |
| title_short | Early Start Of Tenofovir Treatment Achieves Better Viral Suppression In Pregnant Women With A High HBV Viral Load: A Real-World Prospective Study |
| title_sort | early start of tenofovir treatment achieves better viral suppression in pregnant women with a high hbv viral load a real world prospective study |
| topic | tenofovir disoproxil fumarate efficacy safety second trimester third trimester |
| url | https://www.dovepress.com/early-start-of-tenofovir-treatment-achieves-better-viral-suppression-i-peer-reviewed-article-IDR |
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