{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T15:12:01Z","timestamp":1747149121189,"version":"3.40.5"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","license":[{"start":{"date-parts":[[2022,5,20]],"date-time":"2022-05-20T00:00:00Z","timestamp":1653004800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatol Commun"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>The appropriate prophylaxis for hepatitis B virus reactivation (HBVr) during gestation for immunocompromised pregnant women has yet to be determined. The prophylactic efficacy and safety of tenofovir disoproxil fumarate (TDF) in hepatitis B surface antigen (HBsAg)\u2013positive patients and the HBVr risk in hepatitis B core antibody (HBcAb)\u2013positive patients during gestation were investigated. Eligible pregnant women were diagnosed with rheumatic diseases and were administered prednisone (\u226410\u2009mg daily) with permitted immunosuppressants at screening. HBsAg\u2010positive participants were instructed to take TDF; those unwilling to take TDF were followed up as the control group. Propensity score matching was applied to control for differences in confounding factors between the HBcAb\u2010positive and uninfected groups. Hepatopathy, maternal, pregnancy, and safety outcomes were documented as endpoints. A cohort of 1292 women was recruited from 2017 to 2020, including 58 HBsAg\u2010positive patients (29 in each group). A total of 120 pairs in the HBcAb\u2010positive and noninfection groups were analyzed. Among HBsAg\u2010positive patients, 6 (20.7%) cases of hepatitis flare (hazard ratio [HR]: 7.44; 95% confidence interval [CI]: 1.50\u201336.89; <jats:italic toggle=\"yes\">p\u2009=<\/jats:italic>\u00a00.014) and 12 (41.4%) cases of HBVr (HR: 8.71; 95% CI: 2.80\u201327.17; <jats:italic toggle=\"yes\">p<\/jats:italic>\u2009&lt;\u20090.001) occurred in the control group, while 0 occurred in the TDF prophylaxis group. The HBV level at delivery was the lowest (1.6 log<jats:sub>10<\/jats:sub> IU\/ml) for those who received TDF during the pregestation period with a good safety profile. More adverse maternal outcomes were observed in the control group (odds ratio: 0.19, 95% CI: 0.05\u20130.77, <jats:italic toggle=\"yes\">p\u2009=<\/jats:italic>\u00a00.021), including one death from fulminant hepatitis and two cases of vertical transmission. No HBVr was recorded in HBcAb\u2010positive participants. Among immunocompromised pregnant women, prophylactic TDF during pregestation was necessary for HBsAg\u2010positive women, whereas regular monitoring was recommended for HBcAb\u2010positive women.<\/jats:p>","DOI":"10.1002\/hep4.1994","type":"journal-article","created":{"date-parts":[[2022,5,20]],"date-time":"2022-05-20T09:13:52Z","timestamp":1653038032000},"page":"2431-2440","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Prophylactic effect of tenofovir on viral reactivation in immunocompromised pregnant women living with hepatitis B virus"],"prefix":"10.1097","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4683-5209","authenticated-orcid":false,"given":"Le","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Rheumatology,Renji Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai,China"},{"name":"Department of Pharmacy,Renji Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai,China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shaoying","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Rheumatology,Renji Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai,China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yongfu","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Biostatistics,School of Public Health,Key Laboratory of Public Health Safety of Ministry of Education,Fudan University,Shanghai,China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suli","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Rheumatology,Renji Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai,China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuetian","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine,Renji Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai,China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology,Renji Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai,China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aimin","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology,Renji Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai,China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yimin","family":"Mao","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Key Laboratory of Gastroenterology and Hepatology,Ministry of Health,Renji Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai,China"},{"name":"Shanghai Institute of Digestive Disease,Shanghai,China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liangjing","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Rheumatology,Renji Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai,China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2022,5,20]]},"reference":[{"key":"hep41994-bib-0001-20241118","doi-asserted-by":"crossref","first-page":"1542","DOI":"10.1016\/j.semarthrit.2020.03.003","article-title":"RISE registry reveals potential gaps in medication safety for new users of biologics and targeted synthetic DMARDs","volume":"50","year":"2020","journal-title":"Semin Arthritis Rheum"},{"key":"hep41994-bib-0002-20241118","first-page":"1","article-title":"Indications for antiviral therapy for chronic hepatitis B in pregnant mothers","volume":"2016","year":"2016","journal-title":"BMJ Case 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