title: Efficacy and safety of telbivudine in different trimesters of pregnancy with high viremia for interrupting perinatal transmission of hepatitis B virus.
abstract: OBJECTIVE
  We aimed to investigate the efficacy and safety of telbivudine (LdT) on the intervention of mother-to-child transmission (MTCT) in different trimesters of pregnant women with high viral loads.
  
  
  METHODS
  In this prospective cohort study, 160 cases of mothers with high viral loads were included. Eighty-two subjects received 600 mg/day LdT therapy. Fifty of them started LdT therapy before the third trimester of gestation, including 17 cases before pregnancy, nine and 24 cases in the first and second trimesters of pregnancy, respectively. The other 32 cases started LdT in the third trimester of gestation. Control pregnant women (78 cases) did not take LdT therapy. MTCT rate was determined by hepatitis B surface antigen (HBsAg) and hepatitis B virus (HBV) DNA data of infants at the 51st week post-partum. Adverse events were also evaluated throughout the study.
  
  
  RESULTS
  One hundred and sixty infants were born from 160 pregnant women. Both LdT-treated groups displayed a marked decline in HBV DNA levels from the beginning to delivery. Positive rate of serum HBsAg in infants born from the above two groups of mothers were 0% and 3.1%, respectively, which was significantly lower than that in the untreated controls (24.4%). The incidence of detectable HBV DNA levels was significantly lower in infants born to LdT-treated mothers than in the controls (16.7%) at the 51st week post-partum. No infant had birth defects. No severe adverse event or complication were observed in LdT-treated mothers or infants followed until the 51st week post-partum.
  
  
  CONCLUSIONS
  The earlier application of LdT during pregnancy, the better preventive effects it offered on MTCT.
authors: State Key Discipline of Infectious Diseases, Department of Infectious Diseases, Shenzhen, China.
authors: Yingxia
authors: Y
authors: Liu
authors: Department of Obstetrics and Gynecology, Shenzhen Third People's Hospital, Shenzhen, China.
authors: Miao
authors: M
authors: Wang
authors: State Key Discipline of Infectious Diseases, Department of Infectious Diseases, Shenzhen, China.
authors: Simin
authors: S
authors: Yao
authors: State Key Discipline of Infectious Diseases, Department of Infectious Diseases, Shenzhen, China.
authors: Jing
authors: J
authors: Yuan
authors: State Key Discipline of Infectious Diseases, Department of Infectious Diseases, Shenzhen, China.
authors: Jian
authors: J
authors: Lu
authors: State Key Discipline of Infectious Diseases, Department of Infectious Diseases, Shenzhen, China.
authors: Huijuan
authors: H
authors: Li
authors: State Key Discipline of Infectious Diseases, Department of Infectious Diseases, Shenzhen, China.
authors: Wen
authors: W
authors: Zeng
authors: State Key Discipline of Infectious Diseases, Department of Infectious Diseases, Shenzhen, China.
authors: Yong
authors: Y
authors: Deng
authors: State Key Discipline of Infectious Diseases, Department of Infectious Diseases, Shenzhen, China.
authors: Rongrong
authors: R
authors: Zou
authors: Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, China.
authors: Jie
authors: J
authors: Li
authors: State Key Discipline of Infectious Diseases, Department of Infectious Diseases, Shenzhen, China.|Department of Immunobiology, Institute of Tissue Transplantation and Immunology, Jinan University, Guangzhou, China.
authors: Jia
authors: J
authors: Xiao
keywords: hepatitis B virus; mother-to-child transmission; safety; telbivudine