Antiviral Therapy Use for Preventing Perinatal Hepatitis B Infection

• Published in: Pediatrics (Evanston) 2019-08, Vol.144 (2_MeetingAbstract), p.239-239
• Main Authors: Schillie, Sarah, Koneru, Alaya, Nelson, Noele, Lazaroff, Julie, Burkhardt, Elizabeth, Fineis, Pat, Born, Sarah, Hinds, Deborah
• Format: Article
• Language: English
• Subjects: Antiviral agents; Antiviral drugs; Birth weight; Data collection; Demographics; Deoxyribonucleic acid; Disease control; Disease transmission; DNA; Fetuses; Gastroenterology; Globulins; Hepatitis; Hepatitis B; Immunoglobulins; Immunoprophylaxis; Infants; Infections; Infectious diseases; Intrauterine exposure; Lamivudine; Pediatrics; Perinatal exposure; Pregnancy; Tenofovir; Vaccines; Viruses; Womens health
• ISSN: 0031-4005; 1098-4275
• DOI: 10.1542/peds.144.2MA3.239

Purpose: Perinatal exposure, either in utero or more often during delivery, is an important mode of hepatitis B virus (HBV) transmission that results in chronic disease in approximately 90% of infected infants. Immunoprophylaxis (consisting of hepatitis B vaccine and hepatitis B immune globulin [HBIG]) is recommended for infants born to hepatitis B-infected women within 12 hours of birth and is 95% effective in preventing perinatal HBV transmission. For women with high viral loads (>200,000 IU/mL), antiviral therapy during pregnancy has been recently recommended to further reduce perinatal transmission risk. We sought to characterize antiviral therapy use in hepatitis B-infected pregnant women. Methods: The Centers for Disease Control and Prevention (CDC) funds 64 state and local jurisdictions to collect information on pregnant women infected with hepatitis B and their infants as part of its Perinatal Hepatitis B Prevention Program. CDC provided auxiliary funding for five jurisdictions to collect additional information on maternal and infant demographic and clinical characteristics. We analyzed data collected retrospectively from hepatitis B-infected pregnant women in Georgia, Michigan, New York City, Philadelphia, and Wisconsin identified as having delivered live births during April 2016-December 2017. We assessed maternal antiviral therapy use during pregnancy; HBV DNA levels included in our analysis were from the last result available prior to delivery for each woman. Results: We identified 3,971 women with hepatitis B infection during pregnancy; of these, 803 (20.2%) had information regarding prescription of antiviral therapy during pregnancy. HBV DNA levels were known for 1907 women, of whom 9.1% (n=173) had HBV DNA >200,000 IU/mL nearest delivery. Antiviral therapy was prescribed for 26.5% (n=213) of women with information. Antiviral therapy was more commonly prescribed for women aged