Background: Few studies explored whether anti-hepatitis B virus (HBV) therapy should be initiated during postpartum hepatitis flare.
Aim: This study aimed to analyze the effect of anti-HBV therapy on postpartum hepatitis flare and evaluate the prognosis within 4 years postpartum.
Methods: This retrospective study enrolled hepatitis B surface antigen (HBsAg)-positive and hepatitis B e antigen (HBeAg)-positive pregnant women with HBV DNA ≥ 10^{6} IU/mL. A total of 152 pregnant women were included: 103 in the prophylactic anti-HBV therapy group (PT-G) and 49 in the non-prophylactic anti-HBV therapy group (NPT-G). The women with a postpartum flare were assigned to the anti-HBV therapy group (AT-G) and non-anti-HBV therapy group (NAT-G) to analyze the effect of postpartum anti-HBV therapy on hepatitis flare. Virological and biochemical parameters were assessed.
Results: Taking postpartum 12 weeks as the cutoff point, the ALT recovered time for postpartum flare women is shorter in AT-G ( n = 16, 42.1%) or PT-G ( n = 23, 34.8%) than in NAT-G ( n = 14, 23.0%; x ^{2} = 4.067, P =0.044) or NPT-G ( n = 4, 11.1%; x ^{2} = 5.579, P =0.018). Taking postpartum 26 weeks as the cutoff point, the ALT recovered time is shorter in AT-G ( n = 35, 57.3%) or PT-G ( n = 44, 66.7%) than in NAT-G ( n = 32, 84.2%; x ^{2} = 7.707, P =0.006) or NPT-G ( n = 16, 44.4%; x ^{2} = 4.749, P =0.029). Postpartum flare recovery time was positively correlated with HBV DNA level at delivery [ r = 0.223, P =0.025, 95%CI (0.022~0.41)]. The hepatitis re-flare rates within postpartum 4 years in AT-G ( n = 3, 9.68%) is lower than that in NAT-G ( n = 24, 45.4%; x ^{2} = 14.003, P ≤ 0.001). The HBeAg, HBsAg, HBV DNA, and ALT level at postpartum 4 years in AT-G were lower than that in NAT-G ( P < 0.001).
Conclusion: Anti-HBV therapy for postpartum hepatitis flare of women with chronic HBV could shorten the ALT recovery time and reduce hepatitis re-flare rates within 4 years of postpartum.
Antiviral Therapy for a Postpartum Flare in Women with Chronic HBV Infection Shortens the ALT Recovery Time and Reduces Hepatitis Re-Flare Rates within 4 years
[Category] B형 간염,
[Source] pubmed
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