***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE To investigate the efficacy of telbivudine on intrauterine hepatitis B virus ( HBV ) infection during the last stage of pregnancy . METHODS 61 pregnant chronic hepatitis B ( CHB ) patients were enrolled and 31 patients were treated by telbivudine 600 mg once daily , 30 patients in the control group were not received antiviral treatment .  Maternal HBV DNA level and the HBsAg positive rate in newborns were investigated . RESULTS The levels of serum HBV DNA in patients treated with Telbivudine were significantly reduced ( t = 19.09 , P less than 0.01 ) . Compared with the control group , serum HBV DNA levels were significantly lower in telbivudine treated patients than those in the control group before parturition ( t = 23.64 , P less than 0.01 ) . The infection rate of 7-month newborns were 0 and 13.33 % ( 4/30 ) , in telbivudine group and control group , respectively ( x2 = 4.29 , probability value less than 0.05 ) . CONCLUSIONS Telbivudine treatment can block intrauterine infection in pregnant chronic hepatitis B patients A r and omised blind controlled trial of hepatitis B immune globulin ( HBIG ) plus hepatitis B vaccine for the prevention of the perinatally transmitted HBsAg carrier state was conducted in Taipei . Infants of e-antigen-positive HBsAg carrier mothers were given HBIG immediately after birth , and then one of three schedules of vaccination . There was no difference in efficacy between the three schedules ; the combined efficacy was 94 % , compared with that of HBIG alone ( 71 % ) or of vaccination alone ( 75 % ) . Persistent HBs antigenaemia developed in only 9 ( 6 % ) of the 159 infants receiving prophylaxis , but in 88 % of the controls . Antibodies developed in all those who did not become antigenaemic and presumably will provide long-term protection from hepatitis B virus infection . HBIG should be given as soon as possible after birth and need not be given again if the infant is subsequently vaccinated . With HBIG coverage from birth , the timing of the start of vaccination does not seem to be of importance within the first month of life , but to maximise compliance and minimise costs hepatitis B vaccination should be initiated during the confinement Objective To study infectious pathology at index ectopic pregnancy and to determine what other factors predispose a woman to repeat ectopic pregnancy . Methods All women ( n = 697 ) with their first ( index ) ectopic pregnancy histologically verified between January 1 , 1978 , and December 31 , 1993 , at the only two hospitals in one Norwegian county were eligible . Included were permanent residents of the county who were 37 years of age or younger and who had not had tubal surgery before the index pregnancy . When the study closed on November 1 , 1994 , the participants had been observed prospect ively for fertility events from approximately 1 to 17 years . Included in the final analyses were 353 women who had from one to five natural conceptions , for a total of 555 pregnancies . Chisquare test was used in univariate analysis , and the generalized estimating equations approach was used to analyze correlated responses and covariates that changed over time . Results Pregnancy order is the stronger correlate of subsequent ectopic pregnancy . The frequency of repeat ectopic pregnancy decreased by one-third for each pregnancy from the first to the third pregnancy . The odds of having another ectopic pregnancy were nearly three times higher for women with a diagnosis of infectious pathology than for women who had no infectious pathology . Other correlates of repeat ectopic pregnancy include age 24 years or younger at first ectopic pregnancy , history of repeat ectopic pregnancy , initiation of infertility work-up , and conception with an intra-uterine device at index pregnancy . Method of surgery was not associated with repeat ectopic pregnancy . Conclusion The most crucial reproductive event after first ectopic pregnancy is the first event to occur . Women who have experienced two ectopic pregnancies should be considered c and i date s for assisted reproduction BACKGROUND & AIMS Telbivudine reduces hepatitis B virus ( HBV ) DNA and normalizes levels of alanine aminotransferase ( ALT ) in patients with chronic hepatitis B ( CHB ) . We investigated its use in preventing vertical transmission . METHODS We performed an open-label , prospect i ve study of 88 hepatitis B ( HB ) e antigen (HBeAg)-positive pregnant women with CHB , levels of HBV DNA > 6 log(10 ) copies/mL , and increased levels of ALT . Women were given telbivudine ( n = 53 ) starting in the 2nd or 3rd trimester , or no treatment ( controls , n = 35 ) and followed until postpartum week ( PPW ) 28 . All infants received st and ard immunoprophylaxis after birth . RESULTS At 28 weeks , none of the infants whose mothers received telbivudine had immunoprophylaxis failure , whereas 8.6 % of the infants of control mothers did ( P = .029 ) . There were no differences between groups in mothers ' adverse events or infants ' congenital deformities , gestational age , height , and weight , or Apgar scores . At postpartum week 28 , significantly more telbivudine-treated mothers had levels of HBV DNA < 500 copies/mL , normalized levels of ALT , and hepatitis B e antigen seroconversion compared with controls ( 58 % vs none , P < .001 ; 92 % vs 71 % ; P = .008 ; and 15 % vs none ; P < .001 , respectively ) but none had loss of hepatitis B surface antigen .  Telbivudine-treated mothers had no virologic breakthrough ( HBV DNA > 1 log(10 ) increase from < 500 copies/mL ) or discontinuations from adverse events . After delivery , 13/52 patients discontinued telbivudine due to preference . There were no episodes of severe hepatitis ( levels of ALT > 10 times the upper limit of normal ) in either group during 28 weeks of postpartum observation . CONCLUSIONS Women with CHB given telbivudine  during the second or third trimester of pregnancy have reduced rates of perinatal transmission .  Telbivudine produced no adverse events in mothers or infants by 28 weeks BACKGROUND & AIMS In the Asia-Pacific region , perinatal transmission of the hepatitis B virus ( HBV ) is the primary cause of chronic hepatitis B infection . Despite the use of HBIG and HBV vaccination , HBV perinatal transmission ( PT ) occurs in 10 - 30 % of infants born to highly viremic mothers . We evaluated the efficacy and safety of LTD use during late pregnancy in reducing HBV transmission in highly viremic HBeAg+mothers . METHODS Two hundred and twenty-nine HBeAg+HBV DNA levels>1.0 × 10(7 ) copies/ml mothers received telbivudine 600 mg/day from week 20 to 32 of gestation ( n=135 ) or served as untreated controls ( n=94 ) . All infants in both arms received 200 IU of HBIg within 12 h postpartum and recombinant HBV vaccine of 20 μg at 0 , 1 , and 6 months  . HBsAg and HBV DNA results of infants at week 28 were used to determine perinatal transmission rate . All telbivudine treated subjects were registered in the Antiretroviral Pregnancy Registry . RESULTS Telbivudine treatment was associated with a marked reduction in serum HBV DNA and hepatitis B e antigen ( HBeAg ) levels and normalization of elevated ALT levels before delivery . A striking decline of HBV DNA levels started from treatment onset to week 4 , and sustained in a low level since week 12 . Forty-four ( 33 % ) of the 135 telbivudine-treated mothers and none ( 0 % ) of the untreated controls had polymerase chain reaction-undetectable viremia ( DNA<500 copies/ml ) at delivery . Seven months after delivery , the incidence of perinatal transmission was lower in the infants that completed follow-up born to the telbivudine-treated mothers than to the controls ( 0 % vs. 8 % ; p=0.002 ) . HBV DNA levels were only detectable in HBsAg+infants . No significant differences in anti-HBs levels were observed during postnatal follow-up . No serious adverse events were noted in the telbivudine-treated mothers or their infants . CONCLUSIONS Telbivudine used during pregnancy in CHB HBeAg+highly viremic mothers  can safely reduce perinatal HBV transmission . Telbivudine was well-tolerated with no safety concerns in the telbivudine-treated mothers or their infants on short term follow up . These data support the use of telbivudine in this special population To investigate the efficacy of antepartum administration of three doses of hepatitis B immunoglobulin ( HBIg ) , currently being used in China , 250 pregnant women who were seropositive for hepatitis B e antigen ( HBeAg ) were r and omly divided into study ( 117 cases ) and control groups ( 133 cases ) . Subjects in the study group received HBIg 400 IU intramuscularly once a month at the third , second and first month before delivery ; subjects in the control group received no antepartum treatment . All neonates received passive-active immunization after birth . The maternal hepatitis B virus ( HBV ) markers , hepatitis B surface antigen ( HBsAg ) titres and HBV deoxyribonucleic acid ( DNA ) levels were measured at week 28 of gestation ( before the antepartum treatment ) and at labour ; the neonatal serum HBV markers were detected at birth and at 12 months after birth . No side-effects were found in any of the women or their neonates . No statistical differences were seen between the maternal HBsAg and HBV DNA levels of the study and control groups at labour nor the protective efficacy rates of postnatal immunoprophylaxis at 12 months after birth ( P > 0.05 , respectively ) . To conclude , antepartum administration of three doses of HBIg for the HBeAg-positive women is inefficacious Orally administered nucleus(t)ide analogues ( NA ) have brought about a simple , safe and effective therapeutic approach for chronic hepatitis B ( CHB ) . However , treatment duration is long and some female patients become pregnant during treatment . In recent years , there have been gradually increasing reports on the safety of telbivudine ( LdT ) treatment for chronic hepatitis B virus ( HBV ) infection in the third trimester of pregnancy to block mother-to-infant transmission ( MTIT ) of HBV ; however , the safety of LdT treatment for chronic HBV infection for the entire pregnancy has not been reported . The aim of the present study was to evaluate the safety of LdT treatment for chronic HBV infection for the entire pregnancy and provide a reference for HBV-infected fertile women on how to block MTIT of HBV . Eighty-six pregnant women who received LdT treatment either before or in early pregnancy were enrolled in the study . Adverse events were prospect ively observed for the entire pregnancy and perinatal period , and short-term and long-term follow-up of infants was conducted , monitoring the abnormalities of infants and blocking rate of MTIT with LdT treatment . Eighty-six pregnant women treated with LdT had a total of 89 pregnancies : 6 ( 6.7 % ) had  early embryonic death or spontaneous abortion  , 1 ( 1.1 % ) had  ectopic pregnancy  and three had a second pregnancy after initial abortion . Fifty-one mothers completed pregnancy : one had induction of labour at 24 weeks of pregnancy for cleft lip and palate of the foetus and 50 delivered 52 full-term live infants . One infant had right ear accessories , and the total occurrence of congenital abnormality was 3.8 % . Thirty-nine infants were followed up for more than 6 months and completed all examinations for MTIT . None of the infants were HBsAg positive , result ing in a 100 % success rate of blocking MTIT . All mothers maintained good liver function during the third trimester of pregnancy ; 86 % maintained complete virological response ( HBV DNA < 500 copies/mL ) prior to delivery , and none developed progression of liver disease . Factors leading to increased adverse effects and drug resistance were not found . LdT treatment is safe and effective in chronic HBV-infected pregnant mothers for the entire pregnancy 
    Output:
    
Telbivudine is an effective and safe drug for preventing intrauterine transmission of HBV