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Article: Immediate postpartum cessation of tenofovir did not increase risk of virological or clinical relapse in highly viremic pregnant mothers with chronic hepatitis B infection
Title | Immediate postpartum cessation of tenofovir did not increase risk of virological or clinical relapse in highly viremic pregnant mothers with chronic hepatitis B infection |
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Authors | |
Issue Date | 27-Feb-2024 |
Publisher | Elsevier |
Citation | JHEP Reports, 2024 How to Cite? |
Abstract | BackgroundPeripartum prophylaxis (PP) with tenofovir disoproxil fumarate (TDF) is the standard-of-care to prevent mother-to-child transmission (MTCT) of chronic hepatitis B (CHB) infection in highly-viremic mothers. We investigated the maternal and infant outcomes in a large Chinese cohort of TDF-treated CHB pregnant subjects. MethodsIn this prospective study, treatment-naïve non-cirrhotic highly-viremic (hepatitis B virus [HBV] DNA ≥200,000 IU/mL) CHB mothers were treated with TDF at 24-28 weeks of pregnancy. In accordance with Chinese CHB guidelines, TDF was stopped at delivery or ≥4 weeks postpartum. Serum HBV DNA and alanine aminotransferase (ALT) were monitored every 6-8 weeks to determine virological relapse (VR). Infants received standard neonatal immunization and HBV serology were checked at 7-12 months of age. ResultsAmong 330 subjects recruited (median age 30, 82.7% HBeAg+, median HBV DNA 7.82 log IU/mL), TDF was stopped at delivery in 66.4% and ≥4 weeks in 33.6%. VR was observed in 98.3%, among which 11.6% were retreated with TDF. Timing of TDF cessation did not alter the risk of VR (99.0% vs. 96.9%), clinical relapse (19.5% vs. 14.3%) or retreatment (12.3% vs. 10.2%) (all p>0.05). Similar proportion of patients developed ALT flare 5x (2.1% vs 1.0%, p=0.464) and 10x (0.5% vs 0%, p=0.669) above upper limit of normal respectively, in early withdrawal and late withdrawal group. No infants developed HBsAg-positivity. ConclusionPP-TDF and neonatal immunization were highly effective to prevent MTCT of HBV in highly-viremic mothers. Timing of cessation of PP-TDF did not affect the risk of VR or retreatment. |
Persistent Identifier | http://hdl.handle.net/10722/340191 |
ISSN | 2023 Impact Factor: 9.5 2023 SCImago Journal Rankings: 3.409 |
DC Field | Value | Language |
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dc.contributor.author | Chen, Yu | - |
dc.contributor.author | Mak, Lung-Yi | - |
dc.contributor.author | Tang, Mary HY | - |
dc.contributor.author | Yang, Jingyi | - |
dc.contributor.author | Chow, Chun Bong | - |
dc.contributor.author | Tan, Ai-Ming | - |
dc.contributor.author | Lyu, Tao | - |
dc.contributor.author | Wu, Juan | - |
dc.contributor.author | Huang, Qingjuan | - |
dc.contributor.author | Huang, Hai-Bo | - |
dc.contributor.author | Cheung, Ka-Shing | - |
dc.contributor.author | Yuen, Man-Fung | - |
dc.contributor.author | Seto, Wai-Kay | - |
dc.date.accessioned | 2024-03-11T10:42:21Z | - |
dc.date.available | 2024-03-11T10:42:21Z | - |
dc.date.issued | 2024-02-27 | - |
dc.identifier.citation | JHEP Reports, 2024 | - |
dc.identifier.issn | 2589-5559 | - |
dc.identifier.uri | http://hdl.handle.net/10722/340191 | - |
dc.description.abstract | <h3>Background</h3><p>Peripartum prophylaxis (PP) with tenofovir disoproxil fumarate (TDF) is the standard-of-care to prevent mother-to-child transmission (MTCT) of chronic hepatitis B (CHB) infection in highly-viremic mothers. We investigated the maternal and infant outcomes in a large Chinese cohort of TDF-treated CHB pregnant subjects.</p><h3>Methods</h3><p>In this prospective study, treatment-naïve non-cirrhotic highly-viremic (hepatitis B virus [HBV] DNA ≥200,000 IU/mL) CHB mothers were treated with TDF at 24-28 weeks of pregnancy. In accordance with Chinese CHB guidelines, TDF was stopped at delivery or ≥4 weeks postpartum. Serum HBV DNA and alanine aminotransferase (ALT) were monitored every 6-8 weeks to determine virological relapse (VR). Infants received standard neonatal immunization and HBV serology were checked at 7-12 months of age.</p><h3>Results</h3><p>Among 330 subjects recruited (median age 30, 82.7% HBeAg+, median HBV DNA 7.82 log IU/mL), TDF was stopped at delivery in 66.4% and ≥4 weeks in 33.6%. VR was observed in 98.3%, among which 11.6% were retreated with TDF. Timing of TDF cessation did not alter the risk of VR (99.0% vs. 96.9%), clinical relapse (19.5% vs. 14.3%) or retreatment (12.3% vs. 10.2%) (all p>0.05). Similar proportion of patients developed ALT flare 5x (2.1% vs 1.0%, p=0.464) and 10x (0.5% vs 0%, p=0.669) above upper limit of normal respectively, in early withdrawal and late withdrawal group. No infants developed HBsAg-positivity.</p><h3>Conclusion</h3><p>PP-TDF and neonatal immunization were highly effective to prevent MTCT of HBV in highly-viremic mothers. Timing of cessation of PP-TDF did not affect the risk of VR or retreatment.</p> | - |
dc.language | eng | - |
dc.publisher | Elsevier | - |
dc.relation.ispartof | JHEP Reports | - |
dc.rights | This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. | - |
dc.title | Immediate postpartum cessation of tenofovir did not increase risk of virological or clinical relapse in highly viremic pregnant mothers with chronic hepatitis B infection | - |
dc.type | Article | - |
dc.identifier.doi | 10.1016/j.jhepr.2024.101050 | - |
dc.identifier.eissn | 2589-5559 | - |
dc.identifier.issnl | 2589-5559 | - |