Effect of Peg‐interferon α‐2a combined with Adefovir in HBV postpartum women with normal levels of ALT and high levels of HBV DNA

Abstract Background & Aims Currently, routine antiviral treatment is not recommended for immune‐tolerant subjects with chronic HBV infection. In this study, we assessed the treatment efficacy of combining Peg IFN α‐2a with Adefovir ( CPIA ) in chronic HBV infected pregnant women with normal levels of ALT and high levels of HBV after delivery. Methods Chronic hepatitis B pregnant women with normal levels of ALT and high levels of HBV DNA were treated with Telbivudine during the third trimester of their pregnancy. After childbirth, based on serological and virological parameters, the patients were either switched to CPIA treatment for 96 weeks or stopped Telbivudine treatment and followed for 48 weeks. Results A total of 68 patients were enrolled in this study. Thirty (30/68) of them were switched to CPIA treatment after childbirth, 93.3% (28/30) of them achieved virological response, 56.7% (17/30) achieved HB eAg seroclearance and 26.7% (8/30) cleared HB sAg. The HBV DNA and HB eAg levels before CPIA treatment were negatively associated with HB eAg seroclearance. HB sAg and HB eAg levels in week 12 and week 24 after CPIA treatment were negatively associated with HB sAg seroclearance. Thirty‐eight (38/68) patients did not receive antiviral treatment after childbirth, and none of them had HB eAg or HB sAg clearance. Conclusion High rates of viral response and clearance were achieved in chronic hepatitis B pregnant woman with normal levels of ALT and high levels of HBV DNA treated by CPIA after childbirth. (231 words).