LB-6. Tenofovir Disoproxil Fumarate as an Adjunctive Therapy for the Prevention of Vertical Transmission of Hepatitis B Virus Infection
Session: Oral Abstract Session: Late Breaker Oral Abstracts
Saturday, October 5, 2013: 11:30 AM
Room: The Moscone Center: 102 (Gateway Ballroom)
Background: Despite the use of HBIG and HBV immunization, HBV perinatal transmission  occurs in 10–30% of infants born to highly viremic mothers. We evaluated the efficacy and safety of Tenofovir Disoproxil Fumarate (TDF) use during the last trimester of pregnancy as adjunctive therapy to hepatitis B immunization in reducing HBV transmission in highly viremic HBeAg+ mothers.

Method: Between 6/2010 and 6/2013 we evaluated prospectively fourteen pregnant women with chronic hepatitis B infection referred to our clinic who were  HBeAg+ with HBV DNA levels >1.0 x107copies/ml  and received TDF 300 mg/ day from week 28 until delivery. All of the patients included in the study had previously given birth to at least one child infected with hepatitis B despite the immunization with HBIG and HBV vaccine. All infants received HBIG within 12 hours postpartum and recombinant HBV vaccine at 0,1 and 6 months. HBsAg and Anti-HBs results of infants at week 28-32 were used to determine perinatal transmission rate.    

Result: TDF treatment was associated with a marked reduction in serum HBV DNA  before delivery compared with baseline (mean 4.89 ± 1.65 vs  9.12 ± 0.75 log10copies/ml, respectively; p<0.01). All fourteen infants were born without complication and birth defects. All infants were breastfed, had HBsAg negative and Anti-HBs positive results at week 28-32 after birth. 

Conclusion: Our results suggest that TDF used during the thırd trimester of pregnancy in HBeAg+ highly viremic mothers with simultaneous administration of HBIG and HBV vaccine to the newborns  can safely prevent  perinatal HBV transmission. Prospective and larger studies are needed to confirm these findings.

Alper Gunduz, Dilek Yildiz Sevgi, Ahmet Sanli Konuklar, Ahsen Oncul and Nuray Uzun, Infectious Diseases, Hamidiye Sisli Etfal Education and Research Hospital, Istanbul, Turkey

Disclosures:

A. Gunduz, None

D. Y. Sevgi, None

A. S. Konuklar, None

A. Oncul, None

N. Uzun, None

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