Clinical

Lamivudine in late pregnancy can prevent vertical hepatitis B transmission

Last Updated: 2004-11-02 16:49:44 -0400 (Reuters Health)

By Martha Kerr

BOSTON (Reuters Health) - A study conducted by researchers in China indicates that an 8-week course of lamivudine begun late in pregnancy reduces the risk of vertical transmission of hepatitis B (HBV) when the infant also receives hepatitis B vaccination and hepatitis B immunoglobulin after birth.

The results of the study were presented here Tuesday to attendees of the 55th annual meeting of the American Association for the Study of Liver Diseases by Dr. Wei-Min Xu of the Shanghai Infectious Disease Hospital.

Researchers enrolled 114 pregnant women with HBV infection. All were Asian and all had very high viral loads, Dr. Xu noted.

Women were randomized to receive lamivudine 100 mg daily or placebo beginning around week 32 of gestation and continuing until 4 weeks postpartum. Infants received a single dose of hepatitis B immunoglobulin 200 IU at birth and a standard three-dose hepatitis B vaccination course, 10 g/0.5mL, given at birth, 4 weeks and 24 weeks of age.

Dr. Xu reported that 98% of lamivudine-treated women had HBV DNA levels at or below 1000 mEq/mL at delivery compared with 31% of women in the placebo group. Twenty percent of infants in the lamivudine group were HBV DNA-positive compared with 46% of infants in the placebo group. The incidence of adverse events among women and infants was approximately the same in both groups.

Panel moderator Dr. Charles D. Howell of the University of Maryland at Baltimore told Reuters Health that the findings are promising but need much more study. He said he is not yet willing to adopt the practice of giving lamivudine to HBV-positive pregnant women late in pregnancy and it is not standard practice in the US.