替比夫定抗病毒疗效及阻断乙肝病毒宫内传播效果的Meta分析

Antiviral efficacy of telbivudine and its blockage of on intrauterine transmission of hepatitis B virus: a Meta-analysis

目的 评价乙肝孕妇晚期服用替比夫定的抗病毒疗效和阻断宫内传播的效果.方法 从中国期刊全文数据库(CNKI)、万方医学网、中国生物医学文献数据库(CBM)、中国科技期刊数据库(VIP)等中文数据库及PubMed和Science Direct外文数据库中,系统检索从建库开始至2019年7月国内外关于乙肝孕妇服用替比夫定的抗病毒疗效和对宫内传播的阻断效果的文献.按照纳入/排除标准筛选,提取相关信息.结果 共纳入33篇文献,共有试验对象3476人,替比夫定组1597人,对照组1879人,对照组不使用抗病毒药物.替比夫定组孕妇分娩时HBV-DNA水平低于入组前,差异有统计学意义[MD=-4.11,95%CI(-4.49,-3.73),P<0.01],且替比夫定组孕妇分娩时HBV-DNA水平低于对照组,差异有统计学意义[MD=-3.73,95%CI(-4.39,-3.06),P<0.01].替比夫定组新生儿宫内传播率低于对照组,差异有统计学意义[合并RR=2.26,95%CI(1.94,2.63),P<0.01].结论 Meta分析显示,乙肝孕妇晚期服用替比夫定可以通过降低HBV-DNA水平而阻断婴儿宫内传播.

Objective To evaluate the antiviral efficacy of telbivudine in late pregnant women with hepatitis B and its effect in blocking intrauterine transmission of hepatitis B virus(HBV).Methods Internet search in databases including CNKI,Wan-Fang Med Online,CBM,VIP,PubMed and Science Direct was performed to identify the studies on antiviral efficacy of Telbivudine in late pregnant women with hepatitis B and its effect in blocking intrauterine HBV transmission published up to July 2019.According to inclusion and exclusion criteria,the relevant information were extracted.Results Thirty-three articles involving 3476 subjects(Telbivudine group:n=1597,control group:n=1879)were included.The control group was not given antiviral drugs.The HBV-DNA level during delivery in the Telbivudine group was lower than baseline,with statistically significant difference[MD=-4.11,95%CI(-4.49,-3.73),P<0.01].The HBV-DNA level in the Telbivudine group was lower than that in the control group during delivery,with statistically significant difference[MD=-3.73,95%CI(-4.39,-3.06),P<0.01].The intrauterine transmission rate in the Telbivudine group was lower than that in the control group[combined RR=2.26,95%CI(1.94,2.63),P<0.01].Conclusion This meta-analysis shows that oral tibivudine may block the intrauterine HBV transmission by reducing HBV-DNA level in late pregnant women with hepatitis B.