z-logo
Premium
Clinical course of 161 untreated and tenofovir‐treated chronic hepatitis B pregnant patients in a low hepatitis B virus endemic region
Author(s) -
Samadi Kochaksaraei G.,
Castillo E.,
Osman M.,
Simmonds K.,
Scott A. N.,
Oshiomogho J. I.,
Lee S. S.,
Myers R. P.,
Martin S. R.,
Coffin C. S.
Publication year - 2016
Publication title -
journal of viral hepatitis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.329
H-Index - 100
eISSN - 1365-2893
pISSN - 1352-0504
DOI - 10.1111/jvh.12436
Subject(s) - medicine , gastroenterology , hbeag , hepatitis b , hepatitis b virus , tenofovir , pregnancy , viral load , hbsag , immunology , virus , biology , human immunodeficiency virus (hiv) , genetics
Summary Hepatitis B immunoprophylaxis failure is linked to high maternal viraemia. There is limited North American data on hepatitis B outcomes in pregnancy. Pregnant hepatitis B carriers were enrolled January 2011–December 2014 and offered tenofovir in the 3rd trimester if hepatitis B virus ( HBV )‐ DNA was >7‐log IU/mL. Outcomes were determined in treated vs untreated patients. In total, 161 women with 169 pregnancies (one twin, 170 infants; median age 32 years), 18% (29/161) HB eAg+ and median HBV ‐ DNA 2.51 log IU /mL ( IQR 1.66–3.65; range 0.8–8.1) were studied. 14.3% (23/161) received tenofovir due to high viral load (16/23, median 74 days, IQR 59–110) or due to liver disease (7/23). In 10/16 treated due to high viraemia, with confirmed adherence, follow‐up HBV ‐ DNA showed a 5.49 log decline ( P  = 0.003). In treatment naïve mothers, median alanine aminotransferase ( ALT ) increased from 17 IU /L ( IQR 12–24) to 29 ( IQR 18–36) post‐partum ( P  = 1.5e‐7). In seven highly viraemic mothers who declined therapy ( HBV ‐ DNA >8‐log IU /mL); median ALT increased ~3X from baseline ( P  < 0.01). 26% (44/169) had Caesarean section with no difference in treated vs untreated subjects. No tenofovir‐treated mothers had renal dysfunction. Data were available on 167/170 infants; in 50.8% (85/167) who completed immunoprophylaxis, 98.8% (84/85, including 12 exposed to tenofovir in utero ) were HBV immune. One infant born to an HB eAg+ mother with HBV ‐ DNA >8‐log IU /mL failed immunoprophylaxis. In this prospective Canadian cohort study, most untreated mothers experienced mild HBV flares. Tenofovir in pregnancy is well tolerated and reduces viral load prior to parturition.

This content is not available in your region!

Continue researching here.

Having issues? You can contact us here