Case treated with triple therapy of lamivudine, interferon-β and prednisolone for acute exacerbation of chronic hepatitis B during pregnancy.
Case treated with triple therapy of lamivudine, interferon-β and prednisolone for acute exacerbation of chronic hepatitis B during pregnancy.
复制标题
妊娠期慢性乙型肝炎急性加重接受拉米夫定、干扰素-β和泼尼松龙三联疗法治疗的病例。
DOI：
10.1111/j.1872-034x.2012.01077.x
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发表时间：
2013-04
期刊：
影响因子：
--
通讯作者：
Tamai H
中科院分区：
文献类型：
--
作者：
Koh M;Shinohara J;Hongo Y;Okazaki T;Takitani K;Tamai H
我们在此报告一例患有乙型肝炎急性加重的中国孕妇，患者的肝酶在妊娠早期末期升高。她在妊娠中期早期接受拉米夫定、干扰素(IFN)-β和类固醇治疗。该治疗方案开始后，转氨酶水平在4周内迅速恢复正常。在妊娠中期给予IFN-β和类固醇治疗2周，拉米夫定治疗持续至分娩。在妊娠37周自然分娩一名体重2984克的女婴。新生儿检查未发现先天性异常，胎儿生长在正常参考范围内。婴儿在出生后12小时内同时接受主动和被动乙型肝炎病毒免疫接种，并在2、3和5个月大时完成乙型肝炎疫苗接种。这婴儿成功地避免了感染乙型肝炎病毒。本病例提示拉米夫定、干扰素β和类固醇联合治疗在妊娠中期可安全用于治疗乙型肝炎急性加重。
We herein report a case of a pregnant Chinese woman who suffered an acute exacerbation of hepatitis B. The patient's liver enzymes became elevated toward the end of the first trimester. She was treated with lamivudine, interferon (IFN)-β and steroids early in the second trimester. After this treatment regimen was initiated, aminotransferase levels rapidly normalized within 4 weeks. IFN-β and steroids were administrated for 2 weeks in the second trimester, while the administration of lamivudine continued until delivery. The spontaneous delivery of a female baby weighing 2984 g occurred at 37 weeks of gestation. A neonatal examination revealed no congenital anomalies, and fetal growth was found to be within normal reference ranges. The infant received simultaneous active and passive hepatitis B virus immunization within 12 h of delivery and completed the hepatitis B vaccine schedule at 2, 3 and 5 months of age. The infant was successfully prevented from contracting hepatitis B virus. This case suggests that combination therapy with lamivudine, IFN-β and steroids may be safely used during the second trimester to treat acute exacerbations of hepatitis B.