Hepatitis B Virus (HBV) Variants in Untreated and Tenofovir Treated Chronic Hepatitis B (CHB) Patients during Pregnancy and Post-Partum Follow-Up.

摘要: Background Chronic hepatitis B (CHB) is a dynamic disease that may be affected by immune changes in pregnancy. Guidelines suggest consideration of nucleos/tide analogs (NA), i.e., tenofovir, (TDF) highly viremic mothers to reduce vertical transmission risk. HBV variability affects CHB outcome, but little known about genetic pregnancy due or NA selection. Objectives To evaluate diversity treated untreated pregnant vs. post-partum carriers. Study Design In plasma collected from 21 (7 matching pre/post-partum), serological tests, genotype and viral load were assayed. The pre-surface (S) /S overlapping polymerase (P) (N = 20), pre-core (C) /C 11) and/or full genome PCR amplicons 3) underwent clonal sequence analysis. Results The median age was 31 y, 71% Asian, 68% C, 33% eAg+, 5 received TDF (median DNA 8.5 log IU/ml). In mothers, antepartum ALT 24 U/L 2.7 2.4 log(10) IU/ml. flares occurred during period 47% (10/21). Clonal sequencing showed the presence minor “a determinant” vaccine escape mutants (VEM) drug resistant variants infrequent. Analysis samples different diversity. Conclusions Differences selective pressures affect evolution VEM warrant infant follow-up.