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Chinese Journal of Clinical Pharmacology and Therapeutics ›› 2021, Vol. 26 ›› Issue (10): 1146-1152.doi: 10.12092/j.issn.1009-2501.2021.10.006

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Effects of different postpartum withdrawal time of tenofovir on hepatitis B virus markers, virology and biochemical indexes

TAO Chengjing1, LIU Shourong2, CHENG Xiaoxian4, HU Jiannv1, BAI Xiuli1, ZHANG Suying1, ZHAO Chun2, ZUO Zhongbao3   

  1. 1Department of Obstetrics and Gynecology, Hangzhou Xixi Hospital, Zhejiang Chinese Medical University, Hangzhou 310023, Zhejiang, China
  • Received:2020-07-26 Revised:2021-07-21 Online:2021-10-26 Published:2021-11-02

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Abstract: AIM: To evaluate the effect of TDF withdrawal time on changes of serum HBV-M, HBV DNA and ALT level in the mother-to-child blocking of the maternal population. METHODS: A prospective, randomized and controlled study was conducted. The 120 pregnant women with HBV who took TDF during 24 to 28 weeks of gestation were randomly divided into group A (withdrawal at delivery) and group B (withdrawal at 4 weeks postpartum), levels of HBV-M,HBV DNA, and ALT at different times were detected. The results were statistically analyzed by Wilcoxon Rank-sum test and χ2 test. RESULTS: In total, 106 pregnant women have completed testing and follow-up, including 56 in group A and 50 in group B. The levels of HBsAg showed no significant difference in both groups and between the two groups (P>0.05). The levels of HBeAg (M=2.920Log10S/CO) and HBV DNA (M=1.477Log10copies/mL) of group B at withdrawal were significantly lower than group A (M=3.045Log10S/CO, M=2.647Log10 copies/mL). The difference were statistically significant (Z=3.126, P=0.002; Z=－2.940, P＜0.001). The HBeAg serological conversional rate of group B was 22.00%(11/50), which was higher than group A ［8.93% (5/56)］, but it was not statistically significant (P>0.05). The ALT abnormal incidence rate after withdrawal (41.07% in group A and 40.00% in group B) were significantly higher than during pregnancy (19.64% in group A, 16.00% in group B). The difference were statistically significant (group A: χ2=6.081, P=0.014; group B: χ2=7.143, P=0.008); The result of group A and group B compared each was no statistics significant (χ2=0.238, P=0.625). About women with abnormal ALT during pregnancy, the abnormal incidence rate of ALT in group A after withdrawal (100%) was significantly higher than in group B (62.50%) , and the difference was statistically significant (Z=0.696, P=0.048). CONCLUSION: The levels of HBsAg, HBeAg, HBV DNA and ALT have no difference between group A (withdrawal at delivery) and group B(withdrawal at 4 weeks after delivery). About women with abnormal ALT during pregnancy, people in group A show more incurrence than group B after drug withdrawal. Pregnant women with abnormal ALT during pregnancy should enhance postpartum monitoring and delay the drug time when necessary.

Key words: hepatitis B virus, tenofovir, drug withdrawal time

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