Efficacy and Safety of Tenofovir in the Prevention of Perinatal Transmission of Hepatitis B, a Meta-Analysis

Gastroenterol Hepatol. 2020 Dec;43(10):640-648. doi: 10.1016/j.gastrohep.2020.03.015. Epub 2020 Sep 15.
[Article in English, Spanish]

Abstract

Background: Tenofovir disoproxil fumarate (TDF) is recommended for the prevention of perinatal transmission of the hepatitis B virus (HBV). This study aimed to systematically assess the efficacy and safety of TDF in pregnant women with chronic HBV and their infants.

Material and methods: Database searches were performed to identify studies blocking the mother-to-child transmission of the hepatitis B virus with tenofovir. The search included pregnant women with chronic HBV infection administered with TDF compared to the no treatment controls, and data from individual studies were pooled using RevMan v5.3 for meta-analysis.

Results: Seven studies with a total of 911 patients met the inclusion criteria: 433 patients in the TDF group and 478 patients in the non-TDF group. The HBV mother-to-child transmission rate in the tenofovir group was effectively reduced compared to the control group (RR: 0.18, 95% CI: 0.08-0.40). HBV-DNA positivity was also significantly low in infants from TDF group (RR: 0.17, 95% CI: 0.10-0.30) and the TDF treatment resulted in significantly higher anti-HBs production (RR: 1.11, 95% CI: 1.04-1.18). Similarly, maternal HBV-DNA was suppression was significantly high in the TDF group (RR: 34.16, 95% CI: 16.40-71.13). Women treated with TDF and their infants did not result in serious adverse events that are statistically different as compared to the women who did not receive any treatment.

Conclusion: Treatment of HBV infected pregnant women with TDF can effectively and safely prevent the perinatal transmission of chronic hepatitis B.

Keywords: Hepatitis B virus; Meta-analysis; Metaanálisis; Mother-to-child transmission; Tenofovir; Transmisión madre a hijo; Virus de la hepatitis B.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Antiviral Agents / adverse effects
  • Antiviral Agents / therapeutic use*
  • Confidence Intervals
  • DNA, Viral / blood
  • Female
  • Hepatitis B e Antigens / blood
  • Hepatitis B virus / genetics
  • Hepatitis B virus / immunology
  • Hepatitis B, Chronic / transmission*
  • Humans
  • Infant
  • Infant, Newborn
  • Infectious Disease Transmission, Vertical / prevention & control*
  • Observational Studies as Topic
  • Pregnancy
  • Pregnancy Complications, Infectious*
  • Publication Bias
  • Randomized Controlled Trials as Topic
  • Tenofovir / adverse effects
  • Tenofovir / therapeutic use*

Substances

  • Antiviral Agents
  • DNA, Viral
  • Hepatitis B e Antigens
  • Tenofovir