Clinical research of intrahepatic cholestasis of pregnancy complicated by hepatitis B virus infection

WANG Lan; QIN Gang

doi:10.3969/j.issn.1002-7386.2018.12.008

Abstract：Objective To investigate the clinical manifestations and outcome of intrahepatic cholestasis of pregnancy (ICP) complicated by chronic hepatitis B virus (HBV) infection. Methods A total of 112 patients with ICP who were admitted and treated in our hospital from July 2014 to March 2016 were enrolled in the study. These patients were divided into ICP with HBV group ( n =49 ) and simple ICP group ( n =63 ) . The general conditions and laboratory parameters were collected. The patients with ICP were treated by oral ursodeoxycholic acid,and the patients with HBV infection were treated by lamivudine or tenofovir after having obtained the consent of patients. All patients were followed up,moreover the complications of pregnant women and neonates were observed and compared between two groups. Results The incidence rates of ALT, TBIL,TBA,CG and severe ICP in ICP with HBV group were significant higher than those in simple ICP group (P<0. 05). The HBV DNA load was closely positively correlated with ALT (r=0. 430,P<0. 01),AST (r=0. 291,P<0. 05),TBA (r=0.459,P<0.01),TBIL (r =0. 459,P <0. 01) and CG (r =0. 262,P <0. 05) in ICP with HBV group. Moreover the incidence rates of amniotic fluid contamination ( 42. 9%) and fetal distress ( 32. 7%) in ICP with HBV group were significantly higher than those (19. 0% and 15. 9%,respectively) in simple ICP group (P<0. 05). However the neonatal body weight (2726. 80 ± 534. 35g) and 1-minute Apgar scores (7. 27 ± 1. 25) in ICP with HBV group were significantly lower than those (3023. 94 ± 513. 69g and 9. 59 ± 0. 85) in simple ICP group (P<0. 05). Conclusion ICP complicated by HBV infection can results in aggravation of disease condition and poor prognosis of patients with ICP,moreover virology indexes of HBV are associated with clinical parameters.