Letters To The Editor
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World J Gastroenterol. Mar 14, 2013; 19(10): 1671-1672
Published online Mar 14, 2013. doi: 10.3748/wjg.v19.i10.1671
Choice of drugs in the treatment of chronic hepatitis B in pregnancy
Ertugrul Guclu, Oguz Karabay
Ertugrul Guclu, Oguz Karabay, Department of Infectious Diseases and Clinical Microbiology, Sakarya University Faculty of Medicine, 54200 Sakarya, Turkey
Author contributions: Guclu E designed and wrote the paper; Karabay O contributed to the discussion section of article.
Correspondence to: Ertugrul Guclu, Assistant Professor, Department of Infectious Diseases and Clinical Microbiology, Sakarya University Faculty of Medicine, Kemalpaşa Mh 1 Ring Yolu, 54200 Sakarya, Turkey. ertugrulguclu@hotmail.com
Telephone: +90-264-4445400 Fax: +90-264-2759192
Received: December 30, 2012
Revised: February 4, 2013
Accepted: February 7, 2013
Published online: March 14, 2013
Processing time: 73 Days and 22 Hours
Abstract

The selection of antiviral drugs for chronic hepatitis B (CHB) treatment in pregnancy is very difficult since none of the drugs have been approved for use in pregnancy. Transmission from mother to newborn remains the most frequent route of infection in mothers with high viral load and positive hepatitis B e antigen status, even with the use of appropriate prophylaxis with hepatitis B virus (HBV) immunoglobulin and HBV vaccination. We read from the article written by Yi et al that lamivudine treatment in early pregnancy was safe and effective. However, we could not understand why adefovir dipivoxil (ADV) was used in three pregnancy cases, since ADV has been classified as pregnancy category C. In pregnancy, telbivudine or tenofovir should be selected when the treatment of CHB is necessary, since these drugs have been classified as Food and Drug Administration pregnancy risk category B.

Keywords: Pregnancy; Adefovir dipivoxil; Lamivudine; Tenofovir; Entecavir; Chronic hepatitis B; Treatment