Unsatisfying antiviral therapeutic effect in patients with mother-to-child transmissed chronic hepatitis B virus infection: a prospective multi-center clinical study.
Chin Med J (Engl)
; 132(22): 2647-2656, 2019 Nov 20.
Article
em En
| MEDLINE
| ID: mdl-31725459
ABSTRACT
BACKGROUND:
Few data are available regarding the progression of liver disease and therapeutic efficacy in chronic hepatitis B virus (HBV) carriers infected by mother-to-child transmission (MTCT). This study aimed to investigate these two aspects by comparing the adult chronic HBV carriers in MTCT group with those in horizontal transmission group.METHODS:
The 683 adult chronic HBV patients qualified for liver biopsy including 191 with MTCT and 492 with horizontal transmission entered the multi-center prospective study from October 2013 to May 2016. Biopsy results from 217 patients at baseline and 78 weeks post antiviral therapy were collected.RESULTS:
Patients infected by MTCT were more likely to have e antigen positive (68.6% vs. 58.2%, χâ=â-2.491, Pâ=â0.012) than those with horizontal transmission. However, in patients with MTCT, levels of alkaline phosphatase (ALP) (Pâ=â0.031), Fibroscan (Pâ=â0.013), N-terminal propeptide of Type III procollagen (PIIINP) (Pâ=â0.014), and Laminin (LN) (Pâ=â0.006) were high, in contrast to the patients with horizontal transmission for whom the levels of albumin (ALB) (Pâ=â0.041), matrix metalloproteinase-3 (MMP-3) (Pâ=â0.001) were high. The 47.2% of patients with MTCT and 36.8% of those with horizontal transmission had significant liver fibrosis (Pâ=â0.013). Following antiviral therapy for 78 weeks, 21.2% and 38.0% patients with MTCT and horizontal transmission acquired hepatitis B e antigen (HBeAg) clearance, respectively (Pâ=â0.043), and the virological response rates were 54.7% and 74.1% in the MTCT and horizontal groups, respectively (Pâ=â0.005). MTCT was a risk factor for HBeAg clearance and virological response.CONCLUSION:
Adult patients with MTCT were more prone to severe liver diseases, and the therapeutic efficacy was relatively poor, which underlined the importance of earlier, long-term treatment and interrupting perinatal transmission. TRIAL REGISTRATION NCT01962155; https//clinicaltrials.gov.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Transmissão Vertical de Doenças Infecciosas
/
Hepatite B Crônica
Tipo de estudo:
Clinical_trials
/
Observational_studies
/
Risk_factors_studies
Limite:
Adult
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Female
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Humans
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Male
/
Middle aged
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article