***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: This r and omized , double-blind , placebo-controlled study evaluated whether lamivudine given during late pregnancy can reduce hepatitis B virus ( HBV ) perinatal transmission in highly viraemic mothers . Mothers were r and omized to either lamivudine 100 mg or placebo from week 32 of gestation to week 4 postpartum . At birth , infants received recombinant HBV vaccine with or without HBIg and were followed until week 52 . One hundred and fifty mothers , with a gestational age of 26 - 30 weeks and serum HBV DNA > 1000 MEq/mL ( bDNA assay ) , were treated . A total of 141 infants received immunoprophylaxis at birth . In lamivudine-treated mothers , 56 infants received vaccine + HBIg ( lamivudine + vaccine + HBIg ) and 26 infants received vaccine ( lamivudine + vaccine ) . In  placebo-treated mothers , 59 infants received vaccine + HBIg ( placebo + vaccine + HBIg ) . At week 52 , in the primary analyses where missing data was counted as failures , infants in the lamivudine + vaccine + HBIg group had a significant decrease in incidence of HBsAg seropositivity ( 10/56 , 18%vs 23/59 , 39 % ; P = 0.014 ) and in detectable HBV DNA ( 11/56 , 20%vs 27/59 , 46 % ; P = 0.003 ) compared to infants in the placebo + vaccine + HBIg group . Sensitivity analyses to evaluate the impact of missing data at week 52 result ing from a high dropout rate ( 13 % in the lamivudine + vaccine + HBIg group and 31 % in the placebo + vaccine + HBIg group ) remained consistent with the primary analysis in that lower transmission rates were still observed in the infants of lamivudine-treated mothers , but the differences were not statistically significant . No safety concerns were noted in the lamivudine-treated mothers or their infants . Results of this study suggest that lamivudine reduced HBV transmission from highly viraemic mothers to their infants who received passive/active immunization In a hepatitis B vaccination program  ( 1982 - 1992 ) , 705 infants born to HBsAg-positive mothers  received HBIg within 2 h of birth and were vaccinated according to a three- or four-dose vaccination schedule , starting either at 3 months or directly after birth . Eight children HBsAg-positive during the first year of life ( group 1 : infected nonresponders ) . To determine whether failure of the hepatitis B vaccination was due to perinatal high-level maternal viraemia or genetically determined infant nonresponsiveness to the vaccine , we measured HBsAg and anti-HBs levels in infants and HBeAg and hepatitis B virus-DNA levels in maternal serum , and determined the HLA type of the infants . Controls included 14 infants with a normal anti-HBs response 1 year after vaccination ( group 2 : noninfected responders ) and all eight infants without HBsAg and anti-HBs 1 year after vaccination ( group 3 : noninfected low responders ) . HBsAg , HBeAg and anti-HBs were measured by radioimmunoassay ( Abbott Laboratories ) , hepatitis B virus-DNA was measured quantitatively by solution hybridization for groups 1 , 2 , and 3 ( Abbott hepatitis B virus-DNA assay , Abbott Laboratories ) , and HLA was characterized by microcytotoxicity test for groups 1 and 3 . All infants in groups 1 and 2 were born to HBeAg carrier mothers , and those in group 3 to HBeAg-negative mothers . Hepatitis B virus-DNA levels in maternal serum in group 1 were significantly higher than in group 2 ( Wilcoxon rank-sum test : p < 0.01 ) . Hepatitis B virus-DNA was not observed in group 3 maternal serum sample s. ( ABSTRACT TRUNCATED AT 250 WORDS BACKGROUND & AIMS Fetal safety of antiviral therapies is important given the long-term treatment of women with chronic hepatitis B ( CHB ) infection who may become pregnant . We analyzed neonatal safety data from the Antiretroviral Pregnancy Registry ( APR ) , the largest safety data base in pregnancy for antivirals used for HIV and CHB . METHODS Data were extracted from APR cases prospect ively enrolled between 1989 and 2011 . Primary outcomes were major birth defects rates with exposure to all antivirals , individual classes , and drugs compared to population -based controls . Relevant to CHB , only lamivudine ( LAM ) and tenofovir disoproxil fumarate ( TDF ) had sufficient individual data for review ( ≥200 cases ) . RESULTS Of 13,711 cases analyzed , the overall birth defect prevalence ( 2.8 % , 95 % CI 2.6 - 3.1 % ) was comparable to Centers for Disease Control population -based data ( 2.72 % , 2.68 - 2.76 % , p=0.87 ) and two prospect i ve antiretroviral exposed newborn cohorts ( 2.8 % , 2.5 - 3.2 % , p=0.90 and 1.5 % , 1.1 - 2.0 % , p<0.001 ) . The birth defects prevalence between first and second/third trimesters exposure was similar ( 3.0 % vs. 2.7 % ) . No increased risk of major birth defects with LAM or TDF exposure compared to population -based controls was observed . No specific pattern of major birth defects was observed for individual antivirals or overall . CONCLUSIONS No increased risk of major birth defects including in non-live births was observed for pregnant women exposed to antivirals relevant to CHB treatment overall or to LAM or TDF compared to population -based controls . Continued safety and efficacy reporting on antivirals in pregnancy are essential to inform patients on their risks and benefits during pregnancy 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 AIM To evaluate the safety of lamivudine ( LAM ) treatment for chronic hepatitis B in early pregnancy . METHODS A total of 92 pregnant women who received LAM treatment either before pregnancy or in early pregnancy were enrolled in this study . All of the pregnant women volunteered to take lamivudine during pregnancy and were not co-infected with hepatitis C virus , human immunodeﬁciency virus , cytomegalovirus , or other viruses . All infants received passive-active immunoprophylaxis with 200 IU hepatitis B immunoglobulin and three doses of 10 μg hepatitis B vaccines ( 0 - 1 - 6 mo ) according to the guidelines for the prevention and treatment of chronic hepatitis B. Adverse events were observed throughout the entire pregnancy and perinatal period , and the effectiveness of lamivudine treatment for blocking mother-to-infant transmission of hepatitis B virus ( HBV ) was evaluated . All adverse events in mothers and infants during pregnancy and the perinatal period and the HBV mother-to-infant transmission blocking rate were compared with the literature . RESULTS Among the 92 pregnant women , spontaneous abortions occurred in 11 cases , while 3 mothers had a second pregnancy after the initial abortion ; 72 mothers delivered 73 live infants , of whom 68 infants were followed up for no less than 6 mo , and 12 mothers were still pregnant . During pregnancy , the main maternal adverse events were vaginitis ( 12/72 , 16.7 % ) , spontaneous abortion ( 11/95 , 11.6 % ) , and gestational diabetes ( 6/72 , 8.3 % ) ; only one case had 1 - 2 degree elevation of the creatine kinase level ( 195 U/L ) . During the perinatal period , the main maternal adverse events were premature rupture of the membranes ( 8/72 , 11.1 % ) , preterm delivery ( 5/72 , 6.9 % ) , and meconium staining of the amniotic fluid ( 4/72 , 5.6 % ) . In addition , 2 infants were found to have congenital abnormalities ; 1 had a scalp hemangioma that did not change in size until 7 mo , and the other had early cerebral palsy , but with rehabilitation training , the infant 's motor functions became totally normal at 2 years of age . The incidence of adverse events among the mothers or abnormalities in the infants was not higher than that of normal mothers or HBV-infected mothers who did not receive lamivudine treatment . In only 2 cases , mother-to-infant transmission blocking failed ; the blocking rate was 97.1 % ( 66/68 ) , which was higher than has been previously reported . CONCLUSION Lamivudine treatment is safe for chronic HBV-infected pregnant mothers and their fetuses with a gestational age of less than 12 wk or throughout the entire pregnancy BACKGROUND Mother to Child Transmission ( MTCT ) has remained a leading cause of HBV infection in China , accounting for 40 % of total infections . Providing hepatitis B vaccine ( HepB ) to all infants within 24h of birth ( Timely Birth Dose , TBD ) , and subsequent completion of at least 3 vaccine doses is key to preventing perinatal HBV infection . In 2002 , with the financial support of the Global Alliance on Vaccine and Immunization ( GAVI ) targeted to Western region and 223 poverty-affected counties in Central region , hepatitis B vaccine was provided for free . In 2010 , we evaluated the China GAVI project in terms of its activities to prevent perinatal infections . OBJECTIVE The objectives of the evaluation were to ( 1 ) measure achievements in the China GAVI project in terms of TBD coverage , and ( 2 ) describe practice s for HBsAg screening of pregnant women and HBIG use outside the GAVI China project . METHODS We used the methods recommended by WHO to select a cluster sample of health care facilities for the purpose of an injection safety assessment . We stratified China into three regions based on economic criteria , and selected eight counties with a probability proportional to population size in each region . In each selected county , we selected ( a ) 10 townships at r and om among the list of townships of the county and ( b ) the one county level hospital . In each hospital , we abstract ed 2002 through 2009 records to collect information regarding birth cohorts , hospitals deliveries , vaccine management , hepatitis B vaccination delivery , HBsAg screening practice s and results , and HBIG administration . In addition , in all hospitals , we abstract ed records regarding the delivery of TBD . RESULTS We visited 244 facilities in the three regions , including 24 county hospitals and 220 township hospitals . We review ed 837,409 birth summary records , 699,249 for infants born at county or township hospitals .  Hospital delivery rates increased from 58 % in 2002 to 93 % in 2009 . Surveyed TBD coverage increased from 60 % in 2002 to 91 % in 2009 ( + 31 % ) . Surveyed TBD coverage among children born in hospitals increased from 73 % in 2002 to 98 % in 2009 . Between 2002 and 2009 , the proportion of pregnant women screened for HBsAg increased from 64 % in 2002 to 85 % in 2009 . In 2009 , the proportion of infants born to women screened and found to be HBsAg positive who did not receive any immunization within 24h after birth ranged from 0 % to 0.7 % across regions . CONCLUSIONS Increased availability of hepatitis B vaccine , along with efforts to improve hospital deliveries , increased TBD coverage in China . This decreased perinatal HBV transmission 
    Output:
    
IP and TDF + IP were dominated as they result ed in less or equal QALYs with higher associated costs .
For pregnant HBV-infected women with high levels of viremia , supplemental use of LdT during late pregnancy combined with postnatal IP for infants is cost-effective in China