2199. Antiviral Therapy Use in Hepatitis B-Infected Pregnant Women
Session: Poster Abstract Session: Hepatitis A, B, and C
Saturday, October 6, 2018
Room: S Poster Hall
Background:

Perinatal Hepatitis B Virus (HBV) transmission results in chronic disease in 90% of infected infants. Immunoprophylaxis reduces perinatal HBV infections by 95%. For women with viral loads >200,000 IU/mL, antiviral therapy during pregnancy is recommended to further reduce perinatal transmission. We sought to characterize antiviral therapy use in Hepatitis B-infected pregnant women.

Methods:

The Centers for Disease Control and Prevention (CDC) provided auxiliary funding for five Perinatal Hepatitis B Prevention Programs. We analyzed data collected retrospectively from Hepatitis B-infected pregnant women in Georgia, Michigan, New York City, Philadelphia, and Wisconsin identified as having live births during April 2016–December 2017. We assessed maternal antiviral therapy use during pregnancy; HBV DNA levels included in our analysis were from the last result available prior to delivery for each woman.

Results:

We identified 3,971 pregnant women with HBV infection; of these, 803 (20.2%) had information regarding prescription of antiviral therapy during pregnancy. HBV DNA levels were known for 1,907 women, of whom 9.1% (n=173) had HBV DNA >200,000 IU/mL nearest delivery. Antiviral therapy was prescribed for 26.5% (n=213) of women with information. Antiviral therapy was more commonly prescribed for women aged <30 years vs. ≥30 years (32.0% vs. 23.1%, p=0.0069), Asian/Pacific Island race vs. white or black (42.7% vs. 2.8% and 6.2%, respectively, p<0.0001), and those whose HBV was monitored by a gastroenterologist/hepatologist vs. maternal fetal medicine or infectious disease specialist (55.1% vs. 10.3% and 36.4%, respectively, p<0.0001). Tenofovir was prescribed for 92.9% of women prescribed antiviral therapy; lamivudine was prescribed for 3.8%.

Conclusion:

Antiviral therapy was prescribed for one-fourth of Hepatitis B-infected women with information and was more commonly prescribed for women who were younger, Asian/Pacific Island race, and who received Hepatitis B care from a gastroenterologist/hepatologist. Although these are preliminary findings and data collection is ongoing, opportunities may exist to improve guideline-concordant antiviral therapy use among Hepatitis B-infected pregnant women.

NOTE: Prevention of perinatal HBV transmission is an off-label use of antiviral therapy.

Sarah Schillie, MD, MPH, MBA1, Noele Nelson, MD, PhD, MPH1, Julie Lazaroff, MPH2, Elizabeth Burkhardt, MSPH3, Patrick Fineis, BA4, Sarah Born, RN5, Deborah Hinds, MPH6 and Alaya Koneru, MPH1, (1)Centers for Disease Control and Prevention, Atlanta, GA, (2)Perinatal Hepatitis B Prevention Unit, New York City Department of Health and Mental Hygiene, New York, NY, (3)Georgia Department of Public Health, Atlanta, GA, (4)Division of Immunization, Michigan Department of Health & Human Services, Lansing, MI, (5)Wisconsin Department of Health Services, Madison, WI, (6)Philadelphia Department of Public Health, Philadelphia, PA

Disclosures:

S. Schillie, None

N. Nelson, None

J. Lazaroff, None

E. Burkhardt, None

P. Fineis, CDC: Grant Investigator , Grant recipient .

S. Born, None

D. Hinds, None

A. Koneru, None

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