Lamivudine treatment and outcome in pregnant women with high hepatitis B viral loads

  • V. Jackson
  • W. Ferguson
  • T. B. Kelleher
  • M. Lawless
  • M. Eogan
  • U. Nusgen
  • S. Coughlan
  • J. Connell
  • J. S. Lambert


Perinatal transmission is the most common mode of hepatitis B virus (HBV) transmission and is a leading cause of chronic infection worldwide. Maternal treatment with lamivudine (LAM) can result in a rapid and significant reduction in HBV viral load (VL) and, thus, mitigate the risk of mother-to-child transmission (MTCT). The aim of this study was to retrospectively evaluate the safety of LAM treatment administered in the third trimester of pregnancy and determine the influence, if any, on infant outcome. The medical charts of all HBV surface antigen (HBsAg)-positive women eligible for treatment with LAM and who registered for antenatal care between 2007 and 2012 were retrospectively reviewed. During the 6-year period, 45 women met the criteria for LAM treatment. Thirty-six women (80 %) accepted treatment; the remaining women declined treatment (5), defaulted from care (3) or transferred to another maternity unit (1). The median duration of treatment was 11.4 weeks (range 5.3–17.4) and the median baseline VL was 1.4 × 108 IU/mL (range 1.8 × 107–1.7 × 108). The median VL at delivery was 2.3 × 105 IU/mL and 60 % of women achieved a VL reduction >2 log10 IU/mL before delivery. No cases of perinatal transmission occurred in the infants born to mothers who received treatment; however, one infant, born to a mother who defaulted from care, was HBV-infected at 8 months. The results suggest that LAM therapy in highly viraemic HBV-infected pregnant women could lower the rate of vertical transmission.


Viral Load Perinatal Transmission Maternal Viral Load High Baseline Viral Load Immunoprophylaxis Failure 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Conflict of interest

The authors declare they have no conflict of interest.

Supplementary material

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ESM 1 (DOC 389 kb)


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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • V. Jackson
    • 1
  • W. Ferguson
    • 1
  • T. B. Kelleher
    • 1
    • 2
  • M. Lawless
    • 1
  • M. Eogan
    • 1
  • U. Nusgen
    • 3
  • S. Coughlan
    • 4
  • J. Connell
    • 4
  • J. S. Lambert
    • 1
    • 2
    • 5
    • 6
  1. 1.Department of Infectious DiseasesThe Rotunda HospitalDublinIreland
  2. 2.Department of Infectious DiseasesThe Mater Misericordiae University HospitalDublinIreland
  3. 3.Department of MicrobiologyThe Rotunda HospitalDublinIreland
  4. 4.The National Virus Reference LaboratoryUniversity College DublinDublinIreland
  5. 5.School of Medicine & Medical ScienceUniversity College DublinDublinIreland
  6. 6.Catherine McAuley Research CentreMater Misericordiae University HospitalDublin 7Ireland

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