Differences of Efficacy Between Tenofovir Alafenamide Fumarate and Tenofovir Disoproxil Fumarate in Pregnant Women With Different Hepatitis B Virus DNA Loads  

作　　者：Chengjing Tao Guanlun Zhou Hongxiu Jiang Chao Chen Yuhao Ju Xingran Tao Ping Zhang Shuorong Liu Guorong Han 

机构地区：[1]Department of Obstetrics and Gynecology,the Second Hospital of Nanjing,Affiliated Hospital to Nanjing University of Chinese Medicine,Nanjing,China [2]Department of Obstetrics and Gynecology,Hangzhou Xixi Hospital Affiliated to Zhejiang Chinese Medical University,Hangzhou,China [3]Department of Hepatology,Hangzhou Xixi Hospital Affiliated to Zhejiang Chinese Medical University,Hangzhou,China

出　　处：《Infectious Microbes & Diseases》2024年第3期134-140,共7页感染微生物与疾病（英文）

基　　金：supported by the Key Project of Hangzhou Science and Technology Bureau of Agriculture and Social Development Scientific Research(2022A04A02);Zhejiang Province Medical and Health Research Project(2018KY628);Hangzhou City Social Development Scientific Research Active Design Project(20172016A03).

摘　　要：Tenofovir alafenamide fumarate(TAF)has been endorsed by guidelines for blockade ofmother-to-child transmission of hepatitis B virus(HBV),given that its efficacy and safety are comparable to tenofovir disoproxil fumarate(TDF).However,there is a lack of comparative studies regarding the treatment efficacy in patients with diverse viral loads.This study retrospectively analyzed 96 hepatitis B e antigen(HBeAg)–positive pregnant women with HBV DNA levels of≥2×10^(5) IU/mL.Based on viral loads(HBV DNA levels),participants in the TAF and TDF groups were stratified into three subgroups,namely,the High-G(titer≥8 log_(10) IU/mL),Middle-G(7 log_(10) IU/mL≤titer<8 log_(10) IU/mL)and Low-G(titer<7 log_(10) IU/mL)subgroups.The primary endpoint was effectiveness of TAF and TDF in patients with varying viral loads,whereas secondary endpoints were hepatitis B surface antigen(HBsAg)positivity in infants at 7 to 12 months and the safety profile for mothers and children.Compared with baseline levels,median HBV DNA levels in mothers were decreased by 4.51 and 4.09 log_(10) IU/mL in the TAF andTDF groups(P=0.04)predelivery,respectively.In the High-G subgroup,the titers were significantly lower in the TAF group(P=0.045).A higher proportion of patients experienced a virus decline of≥4 log_(10) IU/mL in the TAF group compared with the TDF group,with rates of 78.26% versus 58%(P=0.034),respectively.Moreover,the median serum phosphate levels significantly decreased frombaseline to predelivery in the TDF group(P=0.04).Finally,infants in both cohorts tested negative for HBsAg at 7–12 months after delivery.Overall,our findings indicate that TAF can be considered the preferred option for the treatment of HBeAgpositive pregnant women with HBV DNA levels of≥8 log_(10) IU/mL.

关 键 词：hepatitis B virus tenofovir alafenamide fumarate tenofovir disoproxil fumara HBeAg positive HBV DNA 

分 类 号：R512.62[医药卫生—内科学]