What are the WHO recommendation for use of antiviral therapy to prevent vertical transmission of hepatitis B (HBV) (Hep B)?

Updated: Jun 08, 2021
  • Author: Nikolaos T Pyrsopoulos, MD, PhD, MBA, FACP, AGAF; Chief Editor: BS Anand, MD  more...
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Answer

To prevent maternal-fetal HBV transmission, HBsAg-positive gravida who have an HBV DNA ≥5.3 log10 IU/mL (≥200,000 IU/mL) are recommended to receive tenofovir prophylaxis beginning the 28th week of pregnancy until at least birth. [97] This is in addition to the three-dose hepatitis B vaccination in all infants, including a timely birth dose. (Conditional recommendation)

When antenatal HBV DNA testing is not available, HBeAg testing can be used as an alternative study to determine eligibility for tenofovir prophylaxis to prevent mother-to-child transmission of HBV. [97] (Conditional recommendation)

For HIV-infected pregnant and breastfeeding women (including those in the first trimester of pregnancy and women of childbearing age), the recommended first-line ART is a once-daily fixed-dose combination of tenofovir/lamivudine (or emtricitabine)/efavirenz (applicable to lifelong treatment as well as to ART initiated for the prevention of mother-to-child HBV transmission and then stopped). [55] (Strong recommendation)


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