Tenofovir Disoproxil Fumarate for Prevention of Vertical Transmission of Hepatitis B Virus Infection by Highly Viremic Pregnant Women: A Case Series

Digestive Diseases and Sciences, 05/10/2012

The preliminary data suggest that Tenofovir Disoproxil Fumarate (TDF) use in the third trimester is safe, and effectively prevents vertical transmission (VT) of hepatitis B virus (HBV) from high viremic HBeAg–positive mothers.

Methods

  • Data were collected retrospectively from HBV mono-infected, hepatitis B e antigen (HBeAg) positive, pregnant women between 6/2008 and 11/2010.
  • Cases enrolled were HBV mono-infected mothers who received TDF (300 mg orally once a day) in the third trimester.
  • Those with pregnancy complications or an abnormal fetus on sonography were excluded from use of TDF.
  • All infants received hepatitis B immunoglobulin and vaccination at birth and subsequently.

Results

  • Eleven Asian mothers received TDF at the median gestational age of 29 (28-32) weeks and the median duration of TDF use before delivery was 10 (7-12) weeks.
  • A significant reduction in serum HBV-DNA was achieved at delivery compared with baseline (mean 5.25 ± 1.79 vs. 8.87 ± 0.45 log10 copies/mL, respectively; p < 0.01).
  • Three had serum ALT levels more than 1.5 times the upper limit of normal and two of these normalized before delivery.
  • The 11 infants were born with no obstetric complication or birth defects.
  • Five infants were breastfed.
  • All infants were hepatitis B surface antigen negative 28-36 weeks after birth.

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