655: Tenofovir to prevent mother-to-child transmission of hepatitis B virus: systematic review with meta-analysis

Tenofovir disoproxil fumarate (TDF) has been shown to reduce mother-to-infant hepatitis B virus (HBV) transmission in some studies. We conducted a systematic review and meta-analysis on the efficacy of tenofovir to prevent mother to child transmission of hepatitis B virus. Medline, Scopus, ClinicalTrials.gov, Embase, and the Cochrane Library at the CENTRAL Register of Controlled Trials were searched for the following terms: “tenofovir”, “hepatitis B”, and “pregnancy” from inception of each database until August 2018. No language restrictions were applied. We included all prospective comparative trials of tenofovir administration vs. controls for pregnant patients with chronic hepatitis B infection assessing mother to child transmission rates. The primary outcome was newborn HBsAg positivity at 6-9 Months. Meta-analysis was performed using a random effects model to produce summary treatment effects in terms of odds ratio, with 95% confidence intervals. Heterogeneity was measured using Chi-square and I2 statistics. The quality of the evidence was assessed using the Cochrane Risk of Bias assessment tool. Data analysis was conducted with Review Manager v. 5.3. Five studies (two randomized controlled trials, three non-randomized controlled trials) that enrolled 813 women were included. The results from comparative trials showed that maternal treatment with tenofovir did not significantly reduced the risk of infant hepatitis B surface antigen seropositivity between 6-9 months of age (odds ratio = 0.39, 95% confidence intervals = 0.10, 1.50, P = 0.17) I2 44%. For pregnant women with hepatitis B virus, tenofovir administration did not prevent mother to child transmission when combined with hepatitis B immunoglobulin and the hepatitis B vaccine. Further well-designed RCTs are necessary to confirm the findings of this study.