International Journal of Pregnancy and Childbirth

International Journal of Pregnancy and Childbirth Vol. 1 (1), pp. 001-007, January, 2015. © Advanced Scholars Journals

Full Length Research Paper

Tenofovir and lamivudine in late pregnancy to prevent perinatal transmission of hepatitis B virus in highly viremic mothers in Vietnam

Nguyen Van Bang1, Le Thi Lan Anh1, Nguyen Thi Van Anh2, Vu Tuong Van3, Philippe Halfon4 and Marc Bourlière5

1Department of Pediatrics,Hanoi Medical University, Vietnam.

2Department of Medical Education/Skills Lab,Hanoi Medical University, Vietnam.

3Department of Microbilogy, Machmai Hospital, Vietnam.

4 AlphaBio Labo, European Hospital, Marseille, France

5Department of Gastro-hepatology, Saint Joseph Hospital, Marseille, France.

E-mail: hongbang52@yahoo.com

Abstract

We evaluated effect and safety of lamivudine and tenofovir in late pregnancy for preventing perinatal transmission of hepatitis B virus (HBV) to infants born to highly viremic mothers. A total of 82 pregnant chronic HBsAg(+) women with high viremia (>107 copies/mL) at 32 weeks of gestation were randomly located in 2 groups (lamivudine 100mg or tenofovir 300mg daily for 8 weeks of prepartum to week 4 pospartum). Infants received recombinant HBV vaccine without HBIg and were followed until week 52. We noted a sharp decrease of mean maternal viral load from 5.09 x 108 ± 3.19 x 108 copies/mL at week 32 of gestation to 1.13 x 106 ± 3.91 x 106 at labor (p<0.001) with 2 undetectable HBV DNA cases (2.4%). The viral load reduction was stronger in tenofovir-treated mothers than in lamivudine-treated ones (p<0.028), particularly in 4 log10 reduction (p<0.001). At birth, HBsAg was positive in 21/82 (25.6%) and HBV DNA detectable in 7/82 newborns (8.5%). At week 52, HBsAg and HBV DNA was present in serum of 2/82 infants (2.4%). Both tenofovir and lamivudine in late pregnancy showed the same safety and strikingly reduced perinatal transmission of HBV to infants born to highly viremic mothers.

Key Words: Hepatitis B virus, mother-to-child perinatal transmission, highly viremic women, lamivudine, tenofovir; late pregnancy.

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