Reuters Health Information (2004-11-02): Lamivudine in late pregnancy can prevent vertical hepatitis B transmission
Lamivudine in late pregnancy can prevent vertical hepatitis B transmission
Last Updated: 2004-11-02 16:49:44 -0400 (Reuters Health)
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
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
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.