Oral Antiviral Agents During and After Pregnancy to Prevent Vertical Hepatitis B Transmission

Globally, hepatitis B virus (HBV) infection is commonly caused by peripartum transmission from mother to infant, which can be averted with neonatal vaccination and administration of HBV immune globulin. To further lower risk for transmission, the American Association for the Study of Liver Diseases recommends third-trimester antiviral therapy in pregnant women with hepatitis B surface antigen (HBsAg) positivity and HBV DNA levels >200,000 IU/mL. However, the WHO has not supported this approach owing to low-quality evidence. In a trial at 17 public hospitals in Thailand, investigators randomized 331 pregnant women (HBsAg-positive, normal alanine aminotransferase levels, HIV-negative) to daily 300-mg oral tenofovir disoproxil fumarate (TDF) o…