The efficacy of antiviral treatment with nucleus (t)ide analogues during the entire pregnancy

Objective To investigate the efficacy of antiviral treatment with nucleus (t) ide analogues during the entire pregnancy.Method The clinical data were collected from pregnant women with nucleus(t) ide analogues during the entire pregnancy in Beijing Ditan Hospital from 2009 to 2013,including HBV DNA,serum HBV markers and biochemical indicators.The efficacy of antiviral treatment was evaluated according to virological response,HBeAg seroconversion and biochemical response during the entire pregnancy.Results Totally 125 pregnant women were enrolled in this study.There were 14 cases (11.2％) who occured virological breakthrough during pregnancy.Before preganacy,of 125 pregnant women,100 were HBV DNA-negative and 25 were HBV DNA-positive.In HBV DNA-negative women,96 cases continued to maintain complete virological response and other 4 cases occured virological breakthrough during pregnancy.In HBV DNA-positive women before pregnancy,10 (40％) developed virological breakthrough during pregnancy,which was signifcantly higher than in the HBV DNA-negative women (x2 =22.568,P =0.000); 11 (44％) women who continued to use original drug had complete virological response during pregnancy.Before delivery,the rate of HBeAg seroconversion in 89 pregnant women with HBeAg positive before pregnancy was 4.5％ (4/89).4 cases (4/14) had biochemical breakthrough in 14 cases who had breakthrough during pregnancy; The rates of ALT normalization were 100％ from the second trimester of pregnancy to delivery in others mothers.Conclusions Antiviral treatment with nucleus(t) ide analogues during the entire pregnancy was associated with high rates of HBV DNA undetectable and ALT normalization in women with chronic hepatitis B,while the rate of HBeAg seroconversion was low. Key words: Hepatitis B, chronic;  Pregnancy;  Nucleosids;  Treatment octcome