Usage of tenofovir disoproxil fumarate in preventing vertical transmission
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Reviewed by Dat Tien Nguyen, B.A, ScM.
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Posted on September 12th, 2022
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Chronic hepatitis B infection is a public health threat to Vietnam, approximately 8% to 25% of the population is diagnosed with the disease. Vertical transmission from infected mother to infant is the most common route; thus, it is essential to reduce the viral load in pregnant women to prevent new incidence of infection. A recent review analyzed the current literature to examine the effect of tenofovir disoproxil fumarate therapy on expecting mother and infant.
The literature review included data from 27 studies, and it reported that usage of tenofovir disoproxil fumarate (TDF) has a 97.7-100% effectiveness at preventing vertical transmission. However, the success of the therapy is heavily correlated with the disease burden of the mother: mothers with HBV-DNA level below 5.3 log IU/ml experience no breakthrough infection. However, in mothers with HBV-DNA level above 7.3 log IU/ml, the therapy failure rate is 9%. Thus, it is recommended that immunoprophylaxis should be started when HBV-DNA level is above 5.3 log IU/ml.
Treatment with tenofovir disoproxil fumarate is very well tolerated by the expecting mother. Nausea is the most commonly reported side effect, and there is no serious event associated with the therapy. The therapy is also safe for the neonates: TDF does not increase the risk of premature birth, congenital malformation, growth impairment, and nephrotoxicity.
With the proven effectiveness and safety of tenofovir disoproxil fumarate in preventing vertical transmission, healthcare professionals and public health officials should follow this line of research and make appropriate recommendations to the clinical guideline.
The literature review included data from 27 studies, and it reported that usage of tenofovir disoproxil fumarate (TDF) has a 97.7-100% effectiveness at preventing vertical transmission. However, the success of the therapy is heavily correlated with the disease burden of the mother: mothers with HBV-DNA level below 5.3 log IU/ml experience no breakthrough infection. However, in mothers with HBV-DNA level above 7.3 log IU/ml, the therapy failure rate is 9%. Thus, it is recommended that immunoprophylaxis should be started when HBV-DNA level is above 5.3 log IU/ml.
Treatment with tenofovir disoproxil fumarate is very well tolerated by the expecting mother. Nausea is the most commonly reported side effect, and there is no serious event associated with the therapy. The therapy is also safe for the neonates: TDF does not increase the risk of premature birth, congenital malformation, growth impairment, and nephrotoxicity.
With the proven effectiveness and safety of tenofovir disoproxil fumarate in preventing vertical transmission, healthcare professionals and public health officials should follow this line of research and make appropriate recommendations to the clinical guideline.