Brief Article
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World J Gastroenterol. Dec 28, 2013; 19(48): 9377-9382
Published online Dec 28, 2013. doi: 10.3748/wjg.v19.i48.9377
Efficacy and safety of tenofovir disoproxil fumarate in pregnancy for the prevention of vertical transmission of HBV infection
Mustafa Kemal Celen, Duygu Mert, Müzeyyen Ay, Tuba Dal, Safak Kaya, Necmettin Yildirim, Serda Gulsun, Tunga Barcin, Sevgi Kalkanli, Mehmet Sinan Dal, Celal Ayaz
Mustafa Kemal Celen, Celal Ayaz, Department of Infectious Diseases, Faculty of Medicine, Dicle University, 21280 Yenişehir, Diyarbakir, Turkey
Duygu Mert, State Hospital, 72000 Merkez, Batman, Turkey
Müzeyyen Ay, State Hospital, Kiziltepe, 47500 Mardin, Turkey
Tuba Dal, Department of Medical Microbiology, Faculty of Medicine, Dicle University, 21280 Yenişehir, Diyarbakir, Turkey
Safak Kaya, Department of Infectious Disease, Teaching and Research Hospital, 21100 Diyarbakir, Turkey
Necmettin Yildirim, Department of Infectious Diseases, State Hospital, 47000 Mardin, Turkey
Serda Gulsun, Department of Infectious Diseases, State Hospital, 21100 Diyarbakir, Turkey
Tunga Barcin, Department of Infectious Diseases, Mardin Park Hospital, 47000 Mardin, Turkey
Sevgi Kalkanli, Department of Immunology, Faculty of Medicine, Dicle University, 21280 Yenişehir, Diyarbakir, Turkey
Mehmet Sinan Dal, Department of Internal Medicine, Faculty of Medicine, Dicle University, 21280 Yenişehir, Diyarbakir, Turkey
Author contributions: All authors contributed to this paper.
Correspondence to: Tuba Dal, MD, Associate Professor, Department of Medical Microbiology, Faculty of Medicine, Dicle University, Altunbay 3, 21280 Yenişehir, Diyarbakir, Turkey. tuba_dal@yahoo.com
Telephone: +90-412-248800 Fax: +90-412-2488042
Received: June 24, 2013
Revised: August 17, 2013
Accepted: August 28, 2013
Published online: December 28, 2013
Processing time: 203 Days and 22 Hours
Abstract

AIM: To evaluate the effects of tenofovir disoproxil fumarate (TDF) use during late pregnancy to reduce hepatitis B virus (HBV) transmission in highly viremic mothers.

METHODS: This retrospective study included 45 pregnant patients with hepatitis B e antigen (+) chronic hepatitis B and HBV DNA levels > 107 copies/mL who received TDF 300 mg/d from week 18 to 27 of gestation (n = 21). Untreated pregnant patients served as controls (n = 24). All infants received 200 IU of hepatitis B immune globulin (HBIG) within 24 h postpartum and 20 μg of recombinant HBV vaccine at 4, 8, and 24 wk. Perinatal transmission rate was determined by hepatitis B surface antigen and HBV DNA results in infants at week 28.

RESULTS: At week 28, none of the infants of TDF-treated mothers had immunoprophylaxis failure, whereas 2 (8.3 %) of the infants of control mothers had immunoprophylaxis failure (P = 0.022). There were no differences between the groups in terms of adverse events in mothers or congenital deformities, gestational age, height, or weight in infants. At postpartum week 28, significantly more TDF-treated mothers had levels of HBV DNA < 250 copies/mL and normalized alanine aminotransferase compared with controls (62% vs none, P < 0.001; 82% vs 61%, P = 0.012, respectively).

CONCLUSION: TDF therapy during the second or third trimester reduced perinatal transmission rates of HBV and no adverse events were observed in mothers or infants.

Keywords: Hepatitis B; Tenofovir; Reverse transcriptase inhibitors; Vertical transmission; Chronic

Core tip: Tenofovir disoproxil fumarate use during late pregnancy reduced hepatitis B virus transmission in highly viremic hepatitis B e antigen positive mothers.