Efcacy of oral antiviral drugs to prevent mother‑to‑child transmission of hepatitis B virus: a networ meta‑analysis

Jia F,  Deng F,  Tong S,  Li S,  Ren H,  Yin W,

Hepatol Int 2020 Mar 04

PMID：32130674;DOI：10.1007/s12072-020-10024-2

 Abstract

 Background Hepatitis B is a serious global health problem. Mother-to-child transmission (MTCT) of hepatitis B virus (HBV) is a major risk factor in the endemicity of HBV infection. Oral antiviral drugs are recommended to highly viremic mothers to decrease MTCT of HBV. The present network analysis compared the efcacy of available treatments to prevent the MTCT of HBV.

 Methods The electronic databases of PubMed, Embase, Web of Science, Scopus, and Wanfang data were searched for eligible studies. Pair-wise meta-analysis and Bayesian network analysis were applied to compare the efcacy of antiviral drugs.

 Results Seventy-fve studies involving 12,740 pregnant females were eligible for analysis. On pair-wise analysis, lamivudine (OR 0.15, 95% CI 0.09–0.25, I-squared=0%), telbivudine (OR 0.07, 95% CI 0.05–0.10, I-squared=0%) and tenofovir (OR 0.07, 95% CI 0.04–0.13, I-squared=0%) signifcantly decreased the MTCT rate. Results of multiple comparisons with ranking probability based on Bayesian analysis showed that tenofovir (SUCRA=96.83%) appeared more efective than the two other drugs.

 Conclusion In addition to active and passive immunoprophylaxis, lamivudine, telbivudine and tenofovir in highly viremic mothers can further decrease MTCT of HBV. Based on direct and indirect evidence, tenofovir appears to be more efective than the two other drugs in the prevention of HBV MTCT.

Keywords Hepatitis B virus · HBV · Mother-to-child transmission · Pregnant female · MTCT · Oral antiviral drugs · Lamivudine · Telbivudine · Tenofovir · Network meta-analysis