根據美國胃腸病學會臨床實踐雜誌《臨床胃腸病學和肝髒病學》6月刊上刊登的一篇文章稱，抗病毒藥物替比夫定可預防乙型肝炎病毒(HBV)在圍產期的傳播。

　　“如果我們減少乙肝的全球發病情況，我們需要首先解決的是母嬰傳播，這是乙型肝炎病毒感染的主要途徑。”研究作者Yuming Wang表示。他來自中國重慶西南醫院傳染病研究所。“我們發現替比夫定不僅可切斷孕婦垂直傳播給嬰兒乙肝病毒的途徑，而且婦女和嬰兒對此藥的耐受性良好。”

　　研究人員對450名乙肝病毒陽性的孕婦（這些孕婦體內有非常高的病毒含量，或者在其血液中有非常明顯的乙肝病毒）進行了前瞻性研究，研究時間在懷孕的最後兩個或三個月內。研究過程中，在24到32孕周期間有279名婦女接受替比夫定(600毫克每天)，171名女性因不願意服用抗病毒藥物而作為對照。在嬰兒出生後6個月後，服用替比夫定的母親的孩子沒有一個被檢測為HBV陽性，而對照組中有14.7%的嬰兒被檢測為HBV陽性。

　　媽媽體內的乙肝病毒水平也減少了：近四分之一服用替比夫定的女性在她們體內已檢測不到乙肝病毒。那些沒有用抗病毒藥物治療的人均測出乙型肝炎病毒陽性。很大一部分服用替比夫定的女性檢測不到臍帶血的HBV的DNA含量(99.1%)，低於對照組臍帶血的HBV的DNA含量(61.5%)。研究過程中婦女和嬰兒沒有嚴重的不良事件或並發症發生。

　　相對於其他推薦口服抗病毒藥物如替諾福韋，服用替比夫定的長期影響還有待探索。

　　乙型肝炎病毒感染了全球近二十億人，是肝髒疾病的主要原因。

　　doi:10.1016/j.cgh.2014.08.043

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　　Telbivudine Prevents Vertical Transmission of Hepatitis B Virus From Women With High Viral Loads: A Prospective Long-Term Study

　　Quanxin Wua, Hongfei Huanga, Xiaowen Sun, Meimin Pan, Yun He, Shun Tan, Yi Zeng, Li Li, Guohong Deng, Zehui Yan, Dengming He, Junnan Licorrespondenceemail, Yuming Wangcorrespondenceemail

　　Background &Aims Hepatitis B virus (HBV) infection is a leading cause of liver diseases. We investigated the efficacy and safety of telbivudine in preventing transmission of HBV from hepatitis B e antigen–positive pregnant women with high viral loads to their infants in an open-label study. Methods We performed a prospective study of 450 hepatitis B e antigen–positive pregnant women with HBV DNA levels greater than 106 IU/mL; 279 women received telbivudine (600 mg/d) during weeks 24 to 32 of gestation, and 171 women who were unwilling to take antiviral drugs participated as controls. All newborns were vaccinated with a recombinant HBV vaccine and hepatitis B immune globulin, according to a standard immunoprophylaxis procedure. Mother-to-child transmission of HBV was determined by detection of hepatitis B surface antigen and HBV DNA in the infant 6 months after birth. Results None of the infants whose mothers were given telbivudine tested positive for of hepatitis B surface antigen at 6 months, compared with 14.7% of infants in the control group (P = 5.317 × 10-8). Levels of HBV DNA also decreased among women given telbivudine; 40 of 172 (23.2%) women given telbivudine had undetectable HBV DNA levels before delivery, compared with none of the controls. A significantly higher proportion of women given telbivudine had undetectable levels of HBV DNA in cord blood (99.1%) than controls (61.5%; P = 1.195 × 10-22). No severe adverse events or complications were observed in women or infants. Conclusions Telbivudine significantly reduces vertical transmission of HBV from pregnant women to their infants; it is safe and well tolerated by women and infants. Antiretroviral Pregnancy Registry Health Care Providers ID: 26592; Government number: Natural Science Foundation of China (NSFC) 30830090, 30972598; and Third Military Medical University Key Project for Clinical Research: 2012XLC05).