Efficacy and safety of tenofovir in interrupting mother-to-infant transmission of pregnant women with high-load HBV infection

Abstract

Objective To investigate the efficacy and safety of tenofovir in interrupting mother-to-infant transmission of pregnant women with high-load hepatitis B virus (HBV) infection. Methods Sixty-five pregnant women with high-load HBV infection admitted to the Department of Infectious Diseases of the First Affiliated Hospital of Zhengzhou University from October 2016 to October 2018 were selected as research subjects. Under the premise of voluntary selection, they were divided into treatment group (35 cases) and control group (30 cases). The treatment group started oral anti-viral treatment from the 24th to 28th week of pregnancy, 300 mg once daily, until 1 month after delivery. The pregnant women in control group were not given antiviral therapy. All newborns received combination immunization. The changes of serum alanine aminotransferase (ALT), creatinine and HBV DNA levels in the two groups were observed. The levels of hepatitis B surface antigen (HBsAg) in all infants at age of 7 months were measured. The length, weight, head circumference, neonatal congenital abnormalities of the newborns and the adverse reactions of the pregnant women after medication were recorded. Results Bfore delivery, the content of HBV DNA (log10) was (2.688±0.871)IU/ml in treatment group, lower than the (8.052±0.594)IU/ml in control group, and the difference was statistically significant (P<0.01). The ALT level before delivery of pregnant women in treatment group was significantly lower than that before treatment, and the difference was statistically significant (P<0.05). All of the infants in the treatment group were negative at age of 7 months, and the prevention rate was 100.0%; compared with the prevention rate of control group (86.7%), the difference was statistically significant (P<0.05). There was no congenital abnormality in the two groups of newborns, and they grew and developed well. One patient in the treatment group suffered mild nausea and vomiting, one patient developed fatigue and dizziness after taking tenofovir, but all of the adverse reactions could be tolerable without drug withdrawal. Conclusions The use of tenofovir in pregnant women with high-load HBV infection can effectively reduce the rate of mother-to-child transmission and it is safe. Key words: Tenofovir; Chronic hepatitis B; Mother-to-infant transmission