Digestive Diseases and Sciences

, Volume 57, Issue 9, pp 2423–2429

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

  • Calvin Q. Pan
  • Li-Jun Mi
  • Chalermrat Bunchorntavakul
  • Jeffrey Karsdon
  • William M. Huang
  • Gaurav Singhvi
  • Marc G. Ghany
  • K. Rajender Reddy
Original Article

DOI: 10.1007/s10620-012-2187-3

Cite this article as:
Pan, C.Q., Mi, LJ., Bunchorntavakul, C. et al. Dig Dis Sci (2012) 57: 2423. doi:10.1007/s10620-012-2187-3

Abstract

Background

Despite appropriate immunoprophylaxis, up to 10 % of infants born to highly viremic hepatitis B virus (HBV–DNA ≥ 7 log IU/mL) mothers are infected with HBV. Use of TDF to prevent vertical transmission (VT) by such mothers has not been evaluated.

Purpose

To evaluate the efficacy and safety of TDF in preventing VT from highly viremic HBV-infected 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.

Conclusion

Our preliminary data suggest that TDF use in the third trimester is safe, and effectively prevents VT of HBV from high viremic HBeAg-positive mothers.

Keywords

Hepatitis B virus Pregnancy Perinatal transmission Prevention Treatment Tenofovir 

Abbreviations

HBV

Hepatitis B virus

VT

Vertical transmission

HBsAg

Hepatitis B surface antigen

HBeAg

Hepatitis B e antigen

HBIG

Hepatitis B immunoglobulin

TDF

Tenofovir disoproxil fumarate

ALT

Alanine aminotransferase

ULN

Upper limit of normal

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Calvin Q. Pan
    • 1
  • Li-Jun Mi
    • 2
  • Chalermrat Bunchorntavakul
    • 3
    • 4
  • Jeffrey Karsdon
    • 5
  • William M. Huang
    • 6
  • Gaurav Singhvi
    • 7
  • Marc G. Ghany
    • 8
  • K. Rajender Reddy
    • 3
  1. 1.Division of Liver Diseases, Department of MedicineMount Sinai Medical Center, Mount Sinai School of MedicineNew YorkUSA
  2. 2.Department of Internal MedicineNew York Downtown HospitalNew YorkUSA
  3. 3.Division of Gastroenterology and Hepatology, Department of MedicineUniversity of PennsylvaniaPhiladelphiaUSA
  4. 4.Division of Gastroenterology and Hepatology, Department of Medicine, Ministry of Public HealthRajavithi HospitalBangkokThailand
  5. 5.Division of Neonatology, Department of PediatricsNew York Downtown HospitalNew YorkUSA
  6. 6.Division of maternal–fetal Medicine, Department of Obstetrics and GynecologyNew York Downtown HospitalNew YorkUSA
  7. 7.Division of Gastroenterology, Department of Internal Medicine, Mt. Sinai ServicesElmhurst HospitalNew YorkUSA
  8. 8.Liver Disease Branch, National Institutes of HealthNational Institute of Diabetes and Digestive and Kidney DiseasesBethesdaUSA

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