Letter: tenofovir disoproxil fumarate is safe for prevention of mother‐to‐child transmission of hepatitis B virus. Authors’ reply

Pan, Calvin Q.

doi:10.1111/apt.15382

Cited by 2 publications

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“…There is discrepancy among guidelines, which rose in the contexts of fewer safety data at the second-trimester treatment of TDF in RCTs, and the necessity of starting TDF earlier than the third trimester for PMTCT at the time of preparing the guidelines. Recently a large real-world study suggested that providing TDF at the second trimester could be more effective in controlling viremia than that in the third trimester [49,50] . In a viral kinetic study by Pan et al, treatment with 24 weeks of TDF was more effective (97%) in reducing HBV DNA levels to < 200,000 IU/ml versus 12 weeks of TDF therapy (94%) in reproductive-age women [51] .…”

Section: Discussion Of Current Challenges Possible Solutions and Rese...mentioning

confidence: 99%

The role of tenofovir disoproxil fumarate for preventing vertical transmission of hepatitis B

Pan

2022

Antiviral Therapy

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Background Since immunoprophylaxis failure can occur if maternal serum hepatitis B virus (HBV) DNA levels are >200,000 IU/ml, tenofovir disoproxil fumarate (TDF) therapy has been investigated for preventing mother to child transmission (PMTCT). Methods A literature search for maternal TDF therapy for PMTCT between 1/1/2015 and 7/1/21 on PUBMED, EMBASE, Cochrane, CNKI, and Wanfang databases was performed. Data from RCTs in English or Chinese were extracted and reviewed. The outcomes of interest included the efficacy and safety of TDF versus placebo for PMTCT. Results Among 11 RCTs identified from the databases, the risk-of-bias was low. All studies demonstrated that maternal TDF therapy initiated from the second or third trimester for highly viremic chronic hepatitis B mothers is highly effective and safe in the PMTCT of HBV, except one RCT performed in Thailand which showed no therapeutic advantage on TDF treatment versus placebo for PMTCT (0% vs 3% transmission). Recent emerging data suggest that maternal TDF therapy initiated at the 2nd or early 3rd trimester in mothers with HBV DNA >200,000 IU/ml achieved viremic control before delivery. In the 4-year long follow-up study for maternal TDF therapy, there were no impacts on infants’ physical growth, psychological or mental development, and bone mineral density after fetal exposure to TDF. In the light of updated efficacy and safety data from RCTs, an algorithm was proposed. The approaches in resource-limit areas were discussed. Conclusions TDF is safe for both mothers and infants as the preferred therapy for PMTCT in highly viremic mothers. TDF should be initiated at the second or early third trimester in the combination of the appropriate infants’ immunoprophylaxis.

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Section: Discussion Of Current Challenges Possible Solutions and Rese...mentioning

confidence: 99%

The role of tenofovir disoproxil fumarate for preventing vertical transmission of hepatitis B

Pan

2022

Antiviral Therapy

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“…[15,44,53,54] Preliminary data from the TA PROHM study demonstrating that tenofovir with full schedule HBV vaccination alone may be similarly effective to hepatitis B immune globulin plus tenofovir and full schedule HBV vaccination for prevention of mother-to-child HBV transmission are encouraging [55] though further studies are needed before widespread adoption of this strategy. Tenofovir alafenamide has a higher safety profile than tenofovir disoproxil fumarate (including in pregnancy), would be preferable to tenofovir to reduce adverse event monitoring requirements and costs, [56] however, remains unaffordable in most countries, and is not yet included in WHO guidelines.…”

Section: Implementation Of Hbv Cure: What Is Requiredmentioning

confidence: 99%

Pathway to global elimination of hepatitis B: HBV cure is just the first step

et al. 2023

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Hepatitis B (HBV) is a major cause of global morbidity and mortality, and the leading cause of liver cancer worldwide. Significant advances have recently been made toward the development of a finite HBV treatment that achieves permanent loss of HBsAg and HBV DNA (so-called “HBV cure”), which could provide the means to eliminate HBV as a public health threat. However, the HBV cure is just one step toward achieving WHO HBV elimination targets by 2030, and much work must be done now to prepare for the successful implementation of the HBV cure. In this review, we describe the required steps to rapidly scale-up future HBV cure equitably. We present key actions required for successful HBV cure implementation, integrated within the World Health Organization (WHO) Global Health Sector Strategy (GHSS) 2022–2030 framework. Finally, we highlight what can be done now to progress toward the 2030 HBV elimination targets using available tools to ensure that we are preparing, but not waiting, for the cure.

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Letter: tenofovir disoproxil fumarate is safe for prevention of mother‐to‐child transmission of hepatitis B virus. Authors’ reply

Abstract: Linked ContentThis article is linked to Wang et al and Fan et al papers. To view these articles, visit https://doi.org/10.1111/apt.15064 and https://doi.org/10.1111/apt.15305.

Cited by 2 publications

References 10 publications

The role of tenofovir disoproxil fumarate for preventing vertical transmission of hepatitis B

The role of tenofovir disoproxil fumarate for preventing vertical transmission of hepatitis B

Pathway to global elimination of hepatitis B: HBV cure is just the first step

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