Lamivudineversustenofovir for preventing mother-to-child transmission of hepatitis B virus in highly viremic pregnant women: A prospective, matched cohort study

Abstract

Objective: To evaluate the efficacy and safety of lamivudine and tenofovir in preventing mother-to-child transmission of hepatitis B virus (HBV) in pregnant women with chronic HBsAg positivity and high viral load.

Methods: A prospective, matched cohort study was conducted on pregnant women with high viral load (>10⁶ copies/mL) from March 2015 to March 2018 at two hospitals in Vietnam. Infants born to these women were followed up until January 2019. Data were collected on maternal HBV DNA load, organ function test results, and adverse reactions, as well as infant HBV markers at birth and at 1, 6, and 12 months of age. Data were analyzed between February and June 2019.

Results: A total of 80 pregnant women were enrolled and divided into lamivudine group (n=39) and tenofovir group (n=41). In the tenofovir group, the median maternal HBV DNA load decreased sharply from 7.2 (6.8-7.6) log₁₀ copies/mL before treatment to 4.4 (2.8-5.6) log₁₀ copies/ mL at delivery, which was a significantly greater reduction than that observed in the lamivudine group. The mean ALT and creatinine levels in both groups increased by no more than 2-fold compared with baseline, but remained within the normal range. The efficacy of preventing HBV mother-to-child transmission was similar between the two infant groups: 4.8% in the lamivudine group and 3.8% in the tenofovir group.

Conclusions: Tenofovir should be the preferred option for preventing mother-to-child transmission of hepatitis B virus in pregnant women with high HBV viral load. Future studies with larger sample sizes and additional control groups are warranted to strengthen the evidence and improve the quality of treatment recommendations.

Keywords

Hepatitis B virus / Lamivudine / Tenofovir / Vertical transmission / Pregnancy

Conflict of interest statement

The authors declare that they have no conflict of interest.

Funding

The authors received no extramural funding for the study.

Authors’ contributions

NHTT contributed to the study conception and design, definition of intellectual content, literature search, data acquisition, data analysis, statistical analysis, and manuscript preparation. DTV participated in clinical studies, manuscript editing, manuscript review, and served as a guarantor of the study. NBV was involved in clinical studies, manuscript editing, manuscript review, and served as a guarantor of the study. All authors read and approved the final manuscript.

Publisher’s note

The Publisher of the Journal remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Edited by Pan Y, Lei Y, Zhang Q

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