Unexpected HBsAg decrease after nucleoside analogues retreatment among HBeAg positive postpartum women: a pilot study.

IF 4 3区医学 Q2 VIROLOGY Virology Journal Pub Date : 2025-02-13 DOI:10.1186/s12985-025-02632-x

Qiao Tang, Chunrui Wang, Hu Li, Zhiwei Chen, Li Zhang, Jing Zhang, Xiaoqing Liu, Yunling Xue, Yue Qiu, Mingli Peng, Yi Zeng, Peng Hu

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引用次数: 0

Abstract

Background: Mother-to-child transmission (MTCT) is one of the main routes of transmission of HBV, and previous studies focused on the efficacy and safety of nucleoside analogues (NAs) in preventing MTCT. There are limited data on virologic changes of chronic hepatitis B (CHB) patients after discontinuing treatment postpartum and the efficacy of retreatment.

Methods: A retrospective-prospective real-world pilot cohort study on pregnant women with CHB was conducted. Biochemical and virological characteristics (HBsAg, HBeAg and HBV DNA) in patients received NAs treatment pre-pregnancy (n = 24), patients discontinued treatment after delivery (n = 88) and retreatment patients (n = 22) were collected during follow-up.

Results: The incidences of HBeAg clearance, half decrease of HBsAg, 0.5 lg decrease of HBsAg and HBsAg < 1000 IU/mL in patients discontinuing treatment postpartum were 5.7% (4/70), 10.0% (8/48), 6.3% (3/48) and 1.6% (1/61), respectively. More significantly decreases of HBsAg, HBeAg and HBV DNA were observed in retreatment patients compared to patients received NAs treatment pre-pregnancy. Significantly higher cumulative incidences of half decrease of HBsAg, 0.5 lg decrease of HBsAg and HBsAg < 1000 IU/mL were achieved in retreatment patients compared to patients received NAs treatment pre-pregnancy. Long-term follow-up results indicated that it is safe for HBeAg positive pregnant patients to discontinue treatment after delivery.

Conclusion: HBeAg positive patients received NAs treatment during pregnancy and discontinued it postpartum can benefit from NAs retreatment because of unexpected decrease of HBsAg, which may be helpful for achieve the goal of functional cure. Trial registration number ClinicalTrials.gov (No.ChiCTR2100054116).

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背景：母婴传播（MTCT）是 HBV 的主要传播途径之一，以往的研究主要关注核苷类似物（NAs）在预防母婴传播方面的有效性和安全性。关于慢性乙型肝炎（CHB）患者在产后停止治疗后的病毒学变化以及再治疗的疗效的数据十分有限：方法：对患有慢性乙型肝炎的孕妇进行了一项回顾性-前瞻性真实世界试点队列研究。随访期间收集了孕前接受 NAs 治疗的患者（24 人）、产后停止治疗的患者（88 人）和再治疗患者（22 人）的生化和病毒学特征（HBsAg、HBeAg 和 HBV DNA）：结果：HBeAg 清除率、HBsAg 下降一半、HBsAg 下降 0.5 lg 和 HBsAg 阳性的发生率：HBeAg阳性患者在妊娠期间接受NAs治疗，产后停止治疗，可从NAs再治疗中获益，因为HBsAg意外下降，这可能有助于实现功能性治愈的目标。试验注册号：ClinicalTrials.gov（编号：ChiCTR2100054116）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Virology Journal 医学-病毒学

CiteScore

7.40

自引率

2.10%

发文量

186

审稿时长

1 months

期刊介绍： Virology Journal is an open access, peer reviewed journal that considers articles on all aspects of virology, including research on the viruses of animals, plants and microbes. The journal welcomes basic research as well as pre-clinical and clinical studies of novel diagnostic tools, vaccines and anti-viral therapies. The Editorial policy of Virology Journal is to publish all research which is assessed by peer reviewers to be a coherent and sound addition to the scientific literature, and puts less emphasis on interest levels or perceived impact.