Post delivery withdrawal time of tenofovir for blocking mother to child transmission of HBV in women with high HBV load during late pregnancy

Abstract

Purpose: To study the withdrawal time of tenofovir disoproxil fumarate (TDF) after delivery in parturient women having high hepatitis B virus (HBV) load who took TDF during late pregnancy to block fetal contact with HBV.
 Methods: This is a retrospective analysis of clinical data of 77 pregnant women close to parturition with high HBV density in Southern Central Hospital of Yunan Province from February 2020 to February 2021. Based on time of drug discontinuation, they were assigned to group A (immediately after delivery, n = 24); group B (1 month after delivery, n = 26), and group C (3 months after delivery, n = 27). All three groups took TDF before delivery. Liver function, with alanine aminotransferase (ALT) was assessed using Roche detection system. Deoxyribonucleic acid of hepatitis B virus (HBV-DNA) was assayed by fluorescence quantitative method. Hepatitis B surface antigen (HBsAg) and HB e antigen (HBeAg) were measured using chemiluminescence microparticle immunoassay (CMIA). All assays were done after 2, 4, 8, 12, 18 and 24 weeks of drug withdrawal.
 Results: All parameters in the three groups of patients returned to normal levels after 2, 4, 8, 12, 18 and 24 weeks of drug withdrawal. In 83 neonates, tests for hepatitis B DNA and surface antigen were negative 1 month after birth, with 100 % block of maternal neonatal transmission, and no HBV infection. The incidence of adverse reactions in pregnant women were 16.67, 19.24 and 18.52 % in groups A, B and C, respectively, with no significant difference (p > 0.05).
 Conclusion: The therapeutic effect of TDF for parturient women with high HBV density is not related to drug withdrawal time after delivery. It is necessary to increase the number of samples in subsequent studies in order to validate the research results.