Preventing mother to child transmission of chronic hepatitis B infection in the setting of a high maternal viral load is challenging.
The idea has emerged from antepartum tenofovir treatment with combination immunoprophylaxis.
Dr Kim and colleagues from Korea, USA demonstrated the efficacy and safety of tenofovir to prevent mother to child transmission of hepatitis B virus.
PubMed, EMBASE, and Cochrane databases were searched through 2016.
Comparative trials of second or third trimester tenofovir administration vs. controls for patients with chronic hepatitis B infection and non-comparative case series assessing mother to child transmission rates and evaluating maternal and foetal safety outcomes were included.
|Tenofovir reduced the risk of infant hepatitis B surface antigen seropositivity by 77%|
|Alimentary Pharmacology & Therapeutics|
The team included 10 studies that enrolled 733 women.
The researchers showed that tenofovir significantly reduced the risk of infant hepatitis B surface antigen seropositivity by 77% without heterogeneity.
In the case series analysis, only 2 cases of mother to child transmission with extremely high maternal viral load and non-compliance to treatment were identified.
The team found that maternal and fetal safety parameters including congenital malformation and foetal death were re-assuring.
Dr Kim's team concludes, "For pregnant women with high hepatitis B virus DNA levels, tenofovir administration in the second or third trimester can prevent mother to child transmission when combined with hepatitis B immunoglobulin and the hepatitis B vaccine."
"Tenofovir is safe and tolerable for both the mother and fetus."