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Telbivudine Therapy in HBeAg-positive Pregnant Women to Prevent Mother-to-infant Transmission of HBV

Phase 4
Completed
Conditions
HBV
Interventions
Registration Number
NCT01637844
Lead Sponsor
Yi-Hua Zhou
Brief Summary

Infants of hepatitis B virus (HBV)-infected mothers with positive hepatitis B e antigen (HBeAg) have an increased risk of becoming infected with HBV. This study will determine whether telbivudine among both hepatitis B surface antigen (HBsAg) and HBeAg positive pregnant women during the third trimester, in addition to standard immunoprophylaxis in infants, will be more effective than standard immunoprophylaxis alone at preventing HBV infections in these infants.

Detailed Description

Infants of HBV-infected mothers with positive HBeAg have an increased risk of becoming infected with HBV. Standard immunoprophylaxis against mother-to-infant transmission of HBV includes administration of hepatitis B immunoglobulin (HBIG) and hepatitis B vaccine; however, approximately 5-15% of the infants are not protected despite having received these preventive measures. It is reported that antiviral prophylaxis among HBV-infected pregnant women can reduce mother-to-infant transmission of HBV. However, more research is needed to obtain the definite conclusion. This study will determine whether telbivudine among HBsAg- and HBeAg-positive pregnant women during the third trimester, in addition to standard immunoprophylaxis in infants, will be more effective than standard immunoprophylaxis alone at preventing HBV infections in these infants.

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
335
Inclusion Criteria
  • pregnant women at 28-32 weeks of gestation
  • both HBsAg and HBeAg positive
  • good compliance
Exclusion Criteria
  • Coinfection of HAV, HCV, HEV, HIV, and STD
  • With history of antiviral treatment against HBV
  • With chronic disease, such as heart and kidney disease, asthma, diabetes, hyperthyroidism, severe anemia, bleeding disease, autoimmune diseases
  • With threatened miscarriage or relevant treatment during the pregnancy
  • With pregnant complications such as pregnancy hypertension, preeclampsia, etc
  • With history of fetal deformity, or fetal deformity detected by ultrasound examination
  • With ALT >10 times upper limit, or total bilirubin >3 times upper limit, of normal value

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
TelbivudineTelbivudineHBsAg- and HBeAg-positive pregnant women at 28-32 weeks of gestation start to orally take telbivudine (600 mg/day) until 4 weeks after delivery. Newborn infants receive standard immunoprophylaxis.
Primary Outcome Measures
NameTimeMethod
HBV serologic markers and alanine transaminase (ALT) levels in infants10 months after birth

HBsAg and HBeAg are tested in umbilical blood and peripheral blood collected at the age of 10 months respectively. ALT is measured at 10 months old.

Secondary Outcome Measures
NameTimeMethod
Women and infants with adverse eventsUp to 10 months after delivery/birth

Adverse events in pregnant women during pregnancy, complications at delivery and postpartum, Apgar score, newborn infant deformity, infant growth and development will be recorded during the study period (up to 10 months after delivery/birth).

HBV DNA quantification and ALT levels in mothersUp to 10 months postpartum

HBV DNA and ALT levels in the pregnant women are measured before taking telbivudine, at birth, 1-2 months after stopping the drug, and 10 months postpartum.

Trial Locations

Locations (3)

Taixing People's Hospital

🇨🇳

Taixing, Jiangsu, China

Zhenjiang Fourth People's Hospital

🇨🇳

Zhenjiang, Jiangsu, China

Nanjing Drum Tower Hospital

🇨🇳

Nanjing, Jiangsu, China

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