Tenofovir Disoproxil Fumarate in Pregnancy Reduces Vertical HBV Transmission

Use of tenofovir disoproxil fumarate (TDF) throughout pregnancy can safely reduce the rate of mother-to-child transmission of hepatitis B virus (HBV) in women with chronic hepatitis B (CHB), according to a study published in the European Journal of Gastroenterology & Hepatology.

In highly endemic areas, vertical transmission is the most common route of HBV, occurring in 70% to 90% of women who are hepatitis B surface antigen (HBsAg) positive and hepatitis B e antigen (HBeAg) positive in the absence of prophylaxis in the infant. Antiviral therapy throughout pregnancy in women with CHB has been suggested; however, data on TDF are limited.

Therefore, researchers in Beijing, China, retrospectively evaluated the effect of TDF 300 mg/day initiated before pregnancy in 81 women with CHB on mother-to-child transmission prevention, maternal and fetal safety, and viral suppression compared with 63 women who did not receive antiviral treatment. All infants in both groups received immunoprophylaxis and infants and mothers were followed for at least 7 months postpartum.

The investigators found that TDF was well tolerated in the mothers, and the rates of neonatal congenital abnormalities were similar between the 2 groups. They also found no significant differences between the 2 groups in infant length and weight, Apgar score, rate of low birth weight, gestational age, or rate of cesarean section. TDF significantly reduced the viral load and alanine aminotransferase levels before delivery, and at 7-month postpartum, the mother-to-child transmission rate was 0% in the TDF-treated group, compared with 6.3% (4/63) in the untreated group (P =.035).

“In conclusion, our study suggests that TDF therapy throughout pregnancy lower[s] HBV DNA levels and reduced the rate of [mother-to-child transmission] in pregnant women with CHB,” stated the study authors. They added that “TDF does not seem to increase the risk of adverse maternal or fetal outcomes.”

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Gao X, Duan X, Cai H, et al. The safety and efficacy of tenofovir disoproxil fumarate used throughout pregnancy for mothers with chronic hepatitis B [published December 31, 2020]. Eur J Gastreonterol Hepatol. doi:10.1097/MEG.0000000000001662