The mother-to-child transmission of hepatitis B virus (HBV) is reduced with tenofovir disoproxil fumarate (TDF) treatment during the third trimester in pregnant chronic HBV patients with a high viral load, show the findings of a trial conducted in China.
The study enrolled 200 hepatitis B e antigen (HBeAg)-positive pregnant women with HBV DNA levels over 200,000 IU/mL. They were randomly assigned to receive either TDF 300 mg/day, beginning at 32 to 34 weeks of gestation and continuing until 4 weeks after delivery, or usual care without antiviral treatment. The women were followed up until week 28 postpartum; all pregnancies were single issue and all infants received HBV immunoprophylaxis.
In the intention-to-treat analysis, which included all women except those who withdrew consent before treatment initiation, TDF treatment significantly reduced the rate of vertical transmission at 28 weeks, with transmission of virus to 5% of 97 infants, compared with 18% of 100 infants born to mothers who received usual care (p=0.007).