报告题目：Real-world clinical data-driven modelling on the initiation time of antiviral prophylaxis among pregnant women with chronic hepatitis B infection

报 告 人：沈明望 教授（西安交通大学）

负 责 人：张香红

报告时间：2025年07月20日（星期日）下午3:30－4:30

报告地点：数学大楼912报告厅

参加人员：教师、研究生、本科生

报告摘要：

Background & Aims: The risk of mother-to-child transmission for pregnant women with chronic hepatitis B (CHB) still exists, especially for those with high HBV DNA levels. The guidelines for initiating prophylaxis for pregnant women with CHB vary across countries. We aimed to explore the latest prophylaxis initiation time for these women.

Methods: We collected the real-world clinical data of 328 pregnant women aged 20-49 with CHB, who were treated with telbivudine or tenofovir disoproxil fumarate, from July 2010 to December 2020 in China. A mathematical model was developed to describe the viral kinetics of HBV after prophylaxis. We calculated the time required to reduce viral load below the threshold value of 5.3 log10 IU/ml. We derived the prophylaxis initiation time by subtracting the required time to threshold from the childbirth gestational week.

Results: The median time for 328 women to reduce HBV DNA levels below the threshold of 5.3 log10 IU/ml was 4.2 (range: 0.2-12.8) weeks, corresponding to a prophylaxis initiation time of no later than 35.1 (25.2-41.4) weeks. Specifically, for women with viral loads >8.0 log10 IU/ml, prophylaxis should be initiated before 33.9 (25.2-39.5) weeks, and even before the lower bound of 25.2 weeks, to maximize clinical safety. For women with viral load >7.0 to<−8.0 log10 IU/ml, prophylaxis should be initiated before 35.5(28.6-39.8) weeks, and for women with viral load >5.3 to <−7.0 log10 IU/ml, prophylaxis should be initiated before 36.2 (28.3-41.4) weeks.

Conclusion: Pregnant women with HBV DNA levels >5.3 to <−8.0 log10 IU/ml can initiate prophylaxis before 28 gestational weeks. However, women with HBV DNA >8.0 log10 IU/ml could consider initiating prophylaxis before 25 weeks.

报告人简介：沈明望，现任西安交通大学公共卫生学院流行病与卫生统计学系 教授/博士生导师，陕西省疾控防控与健康促进研究重点实验室副主任。2017年12月在西安交通大学数学与统计学院获得应用数学博士学位。2015年至2017年在美国德克萨斯大学奥斯汀分校生物统计系公派交流学习两年。入选陕西省青年拔尖人才、陕西省高校科协青年人才托举计划，曾获西安交通大学第三届“徐宗本应用数学论文奖”(一等奖)、第七届“十大学术新人”奖、“十大青年岗位能手”。主要研究方向为传染病动力学建模、生物数学、理论流行病学、人工智能在医学中的应用、卫生经济学评价等交叉学科研究。主持项目10项，包括国家自然科学基金面上项目和青年基金项目、国家重点研发计划子任务、中国博士后科学基金面上项目（一等资助）和特别资助等。已发表SCI论文85篇，其中第一作者/通讯作者41篇，包括Journal of Hepatology（IF：33.0）、The Innovation（IF：25.7，2篇）、BMC Medicine（IF：8.3，2篇）、Lancet Regional Health-Western Pacific（IF：8.1，2篇）、Journal of the International AIDS Society、Journal of Antimicrobial Chemotherapy、Proceedings of the Royal Society B: Biological Sciences、AIDS等，其中1篇被选为世界卫生组织发布指南的卫生经济学证据，并入选为感染医学领域唯一一篇“爱思唯尔（Elsevier）中国金色开放获取高下载论文（2023年第一季度）”，2篇被选为中华医学会感染病学分会、肝病学分会、儿科学分会感染学组和国家感染性疾病临床医学研究中心联合发布的《儿童慢性乙型肝炎防治专家共识》建模证据。受邀以第一作者在Lancet Infectious Diseases（IF：31.0）发表评论2篇、在Lancet Regional Health-Europe（IF：13.0）发表评论1篇。担任BMC Medicine期刊编委、中国抗癌协会肿瘤流行病学专业委员会委员、中国疫苗行业协会疫苗经济学专业委员会委员等。