Effectiveness of tenofovir or telbivudine in preventing HBV vertical transmission for pregnancy

Abstract

To evaluate the efficacy and safety of telbivudine (LdT) and tenofovir (TDF) for preventing hepatitis B virus (HBV) vertical transmission for HBV-positive pregnant women. Pregnant women (n = 145) from January 2013 to June 2017 were enrolled when they met inclusion criteria, which included HBV DNA ≥1.0 × 10 7 copies/mL and increased alanine aminotransferase (ALT) levels. Groups A (n = 58) and B (n = 51) were treated with LdT and TDF, respectively. Group C (n = 36) received no antiviral treatment. All infants were vaccinated with hepatitis B immunoglobulin and HBV vaccine. Vertical transmission of HBV was indicated by the presence of hepatitis B surface antigen (HBsAg) in infants 6 months and 12 months after birth. There is no difference of clinical characteristics of patients among the 3 groups. Serum HBV DNA levels of the 3 groups were similar at baseline (Group A vs. Group B vs. Group C, 7.88 ± 0.65 vs. 7.91 ± 0.75 vs. 7.69 ± 0.53 P = .25). In addition, the after anti-HBV treatment in Groups A and B were significantly decreased. Also, the serum HBV DNA levels in both Groups A and B were lower than that of Group C ( P < .01, both). The HBV infection rate in Group A treated with LdT was not different from Group B treated with TDF. The dynamic changes of serum ALT level were similar. ALT levels were similar among the 3 Groups ( P = .171), while there is statistically significant difference between A and C, and between B and C before delivery ( P < .01). For the infants, there were no significant differences among body weight, height, head circumference, or Apgar score. However, the HBsAg positivity rates of infants in Groups A, B, C at postpartum 24 weeks and 48 weeks was 0%, 0%, and 11.1%, respectively ( P < .001). Administration of LdT or TDF to HBV-infected mothers are effective and safe to block mother-to-infant HBV transmission.

Approach to women who become pregnant while on tenofovir disoproxil fumarate for chronic B hepatitis: A report of two cases

“…22 In a study by Zeng et al, it was reported that pregnant women treated with TDF or LDT did not develop drugrelated complications and that vertical transmission was effectively and safely prevented. 23 Nachega et al reported that, in a meta-analysis covering HIV or HBV-infected pregnant women, antiretroviral treatment including TDF was safe for mother and baby. 7 When the literature is reviewed, case reports show that the use of TDF in pregnant women is safe and effective.…”

A Case Report of a Pregnant Woman with Chronic Hepatit B: Use of Tenofovir in Pregnancy

“…Effective agents in the treatment of chronic HBV infection are Pegylated Interferon, lamivudine, entecavir, adefovir, telbivudine and tenofovir. However, telbivudine, lamivudine and tenofovir are usually preferred in pregnancy because of the more number of studies related to their safe use in pregnancy (7,10,11).…”

Efficacy and safety of antiviral therapy for HBV in different trimesters of pregnancy: systematic review and network meta-analysis

“…Among the selected studies, 3 RCTs [7-9] and 12 non-RCTs [10,[16][17][18][19][20][21][22][23][24][25][26] compared treatment started in the third trimester versus control, 7 non-RCTs compared the timing of second trimester versus control [27][28][29][30][31][32][33], 3 non-RCTs compared first trimester versus control [14,34,35], 4 non-RCTs compared second and third trimester versus control respectively [11,[36][37][38], 3 non-RCTs compared first, second trimester versus control respectively [39][40][41]; 2 non-RCTs compared first, third trimester versus control respectively [12,42], 1 non-RCTs compared first, second trimester, third trimester versus control respectively [13]. No randomized controlled trials were conducted for the treatment that was applied during first or second trimester except for several non-RCTs.…”

“…Forest plot of pair-wised meta-analysis of MTCT at 6-12 months after delivery for non-RCTs. a Antiviral therapy ~ 28 week versus control, b [28][29][30][31][32] week versus control at 6-12 months after delivery. c ~ 28 week versus 28-32 week…”