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: [email protected]

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.