Skip to main content
Erschienen in: Digestive Diseases and Sciences 3/2024

10.02.2024 | Original Article

Effectiveness and Safety of Tenofovir Alafenamide Fumarate in the Prevention of Perinatal Hepatitis B Transmission: A Meta-Analysis

verfasst von: Ji Huang, Cong Cheng, Kangxin Li, Chunping Zhu, Youshun Liu

Erschienen in: Digestive Diseases and Sciences | Ausgabe 3/2024

Einloggen, um Zugang zu erhalten

Abstract

Aim

This study aimed to assess the effectiveness and safety of tenofovir alafenamide fumarate (TAF) in the prevention of mother-to-child transmission (MTCT) of hepatitis B virus (HBV).

Methods

We performed a meta-analysis of studies from the Cochrane Library, PubMed, ClinicalTrials.gov, Web of Science, EMBASE, China National Knowledge Infrastructure (CNKI), China Medical Information Network, and Wanfang databases. The databases were searched from inception to January 7, 2023, for cohort studies and randomized controlled trials (RCTs) comparing the use of TAF antivirals to other antivirals during pregnancy. We combined the data by means of a random-effect DerSimonian-Laird model and risk ratios (RRs) or a random-effect inverse variance model and standardized mean differences (SMDs) to determine the influence on mothers and infants. Our primary outcomes were infant weight, height, head size, birth defects, and Apgar scores. Additionally, we assessed whether newborns tested positive for hepatitis B surface antigen (HBsAg) at birth and at six months of age. The secondary outcomes of our investigation were alterations in levels of HBV deoxyribonucleic acid (DNA), alanine aminotransferase (ALT), total bilirubin (TBIL), blood creatinine, and urine β2-microglobulin (β2-M) in mothers.

Results

An extensive literature search identified 216 relevant publications; three cohort studies and two RCTs were included in this study. A total of 341 mothers were treated with TAF, and 342 were treated with other antiviral agents. TAF was as effective as other antiviral medications at lowering HBV MTCT rates at birth and at 6 months of age and ALT, TBIL, and HBV DNA levels. Moreover, compared with other antiviral drugs, TAF did not affect infant weight, height, head size, Apgar scores, and birth defects or maternal blood creatinine or β2-M levels.

Conclusions

TAF antiviral therapy during pregnancy was found to be safe for both mothers and fetuses.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Zeng QL, Zhang HX, Zhang JY, Huang S, Li WZ, Li GM et al. Tenofovir Alafenamide for Pregnant Chinese Women With Active Chronic Hepatitis B: A Multicenter Prospective Study. Clin Gastroenterol Hepatol 2022;20:2826-2837.e2829.CrossRefPubMed Zeng QL, Zhang HX, Zhang JY, Huang S, Li WZ, Li GM et al. Tenofovir Alafenamide for Pregnant Chinese Women With Active Chronic Hepatitis B: A Multicenter Prospective Study. Clin Gastroenterol Hepatol 2022;20:2826-2837.e2829.CrossRefPubMed
2.
Zurück zum Zitat Sarin SK, Kumar M, Lau GK, Abbas Z, Chan HLY, Chen CJ et al. Asian-Pacific clinical practice guidelines on the management of hepatitis B: a 2015 update. Hepatol Int 2016;10:1–98.CrossRefPubMed Sarin SK, Kumar M, Lau GK, Abbas Z, Chan HLY, Chen CJ et al. Asian-Pacific clinical practice guidelines on the management of hepatitis B: a 2015 update. Hepatol Int 2016;10:1–98.CrossRefPubMed
3.
Zurück zum Zitat Liver EAftSotLEaeeeEAftSot. EASL 2017 Clinical Practice Guidelines on the management of hepatitis B virus infection. J Hepatol 2017;2017:370–398. Liver EAftSotLEaeeeEAftSot. EASL 2017 Clinical Practice Guidelines on the management of hepatitis B virus infection. J Hepatol 2017;2017:370–398.
4.
Zurück zum Zitat Terrault NA, Lok ASF, McMahon BJ, Chang KM, Hwang JP, Jonas MM et al. Update on Prevention, Diagnosis, and Treatment of Chronic Hepatitis B: AASLD 2018 Hepatitis B Guidance. Clin Liver Dis (Hoboken) 2018;12:33–34.CrossRefPubMed Terrault NA, Lok ASF, McMahon BJ, Chang KM, Hwang JP, Jonas MM et al. Update on Prevention, Diagnosis, and Treatment of Chronic Hepatitis B: AASLD 2018 Hepatitis B Guidance. Clin Liver Dis (Hoboken) 2018;12:33–34.CrossRefPubMed
5.
Zurück zum Zitat Ding Y, Cao L, Zhu L, Huang Y, Lin C, Wang Y et al. Efficacy and safety of tenofovir alafenamide fumarate for preventing mother-to-child transmission of hepatitis B virus: a national cohort study. Aliment Pharmacol Ther 2020;52:1377–1386.CrossRefPubMed Ding Y, Cao L, Zhu L, Huang Y, Lin C, Wang Y et al. Efficacy and safety of tenofovir alafenamide fumarate for preventing mother-to-child transmission of hepatitis B virus: a national cohort study. Aliment Pharmacol Ther 2020;52:1377–1386.CrossRefPubMed
6.
Zurück zum Zitat Zeng QL, Yu ZJ, Ji FP, Li GM, Zhang GF, Xu JH et al. Tenofovir Alafenamide to Prevent Perinatal Hepatitis B Transmission: A Multicenter, Prospective. Observational Study. Clinical Infectious Diseases 2021;73:E3324–E3332.CrossRefPubMed Zeng QL, Yu ZJ, Ji FP, Li GM, Zhang GF, Xu JH et al. Tenofovir Alafenamide to Prevent Perinatal Hepatitis B Transmission: A Multicenter, Prospective. Observational Study. Clinical Infectious Diseases 2021;73:E3324–E3332.CrossRefPubMed
7.
Zurück zum Zitat Hu Y, Xu C, Xu B, Hu L, Liu Q, Chen J et al. Safety and efficacy of telbivudine in late pregnancy to prevent mother-to-child transmission of hepatitis B virus: A multicenter prospective cohort study. J Viral Hepat 2018;25:429–437.CrossRefPubMed Hu Y, Xu C, Xu B, Hu L, Liu Q, Chen J et al. Safety and efficacy of telbivudine in late pregnancy to prevent mother-to-child transmission of hepatitis B virus: A multicenter prospective cohort study. J Viral Hepat 2018;25:429–437.CrossRefPubMed
8.
Zurück zum Zitat Liu Z, Chen Z, Cui F, Ding Y, Gao Y, Han G et al. Management Algorithm for Prevention of Mother-to-child Transmission of Hepatitis B Virus (2022). J Clin Transl Hepatol 2022;10:1004–1010.CrossRefPubMedPubMedCentral Liu Z, Chen Z, Cui F, Ding Y, Gao Y, Han G et al. Management Algorithm for Prevention of Mother-to-child Transmission of Hepatitis B Virus (2022). J Clin Transl Hepatol 2022;10:1004–1010.CrossRefPubMedPubMedCentral
9.
Zurück zum Zitat Chinese Foundation for Hepatitis Prevention and Control; Chinese Society of Infectious Diseases CMACSoH, Chinese Medical Association. [Management algorithm for interrupting mother-to-child transmission of hepatitis B]. Zhonghua Gan Zang Bing Za Zhi 2017; 25: 254–256. Chinese Foundation for Hepatitis Prevention and Control; Chinese Society of Infectious Diseases CMACSoH, Chinese Medical Association. [Management algorithm for interrupting mother-to-child transmission of hepatitis B]. Zhonghua Gan Zang Bing Za Zhi 2017; 25: 254–256.
10.
Zurück zum Zitat Kayes T, Crane H, Symonds A, Dumond J, Cottrell M, Di Girolamo J et al. Plasma and breast milk pharmacokinetics of tenofovir alafenamide in mothers with chronic hepatitis B infection. Aliment Pharmacol Ther 2022;56:510–518.CrossRefPubMed Kayes T, Crane H, Symonds A, Dumond J, Cottrell M, Di Girolamo J et al. Plasma and breast milk pharmacokinetics of tenofovir alafenamide in mothers with chronic hepatitis B infection. Aliment Pharmacol Ther 2022;56:510–518.CrossRefPubMed
11.
Zurück zum Zitat Han G, Zhou G, Sun T, Luo X, Xu J, Chen C et al. Tenofovir alafenamide in blocking mother-to-child transmission of hepatitis B virus: a multi-center, prospective study. J Matern Fetal Neonatal Med 2022; 1–8. Han G, Zhou G, Sun T, Luo X, Xu J, Chen C et al. Tenofovir alafenamide in blocking mother-to-child transmission of hepatitis B virus: a multi-center, prospective study. J Matern Fetal Neonatal Med 2022; 1–8.
12.
Zurück zum Zitat Chen RC, Zou J, Long LY et al. Safety and Efficacy of Tenofovir Alafenamide Fumarate in Early-Middle Pregnancy for Mothers With Chronic Hepatitis B. Frontiers in Medicine 2022; 8. Chen RC, Zou J, Long LY et al. Safety and Efficacy of Tenofovir Alafenamide Fumarate in Early-Middle Pregnancy for Mothers With Chronic Hepatitis B. Frontiers in Medicine 2022; 8.
13.
Zurück zum Zitat Ding Y, Cao L, Zhu L, Huang H, Zhang M, Fan X et al. Tenofovir alafenamide fumarate therapy for the prevention of hepatitis b vertical transmission in highly viremic mothers with chronic hepatitis B. Hepatology 2020;72:16A-17A. Ding Y, Cao L, Zhu L, Huang H, Zhang M, Fan X et al. Tenofovir alafenamide fumarate therapy for the prevention of hepatitis b vertical transmission in highly viremic mothers with chronic hepatitis B. Hepatology 2020;72:16A-17A.
14.
Zurück zum Zitat Cumpston M, Li T, Page MJ, Chandler J, Welch VA, Higgins JP et al. Updated guidance for trusted systematic reviews: a new edition of the Cochrane Handbook for Systematic Reviews of Interventions. Cochrane Database Syst Rev 2019; 10: Ed000142. Cumpston M, Li T, Page MJ, Chandler J, Welch VA, Higgins JP et al. Updated guidance for trusted systematic reviews: a new edition of the Cochrane Handbook for Systematic Reviews of Interventions. Cochrane Database Syst Rev 2019; 10: Ed000142.
15.
Zurück zum Zitat Huang J, Liu Y, Liu Y. Antiviral therapy in hepatitis B virus-infected with immune-tolerant: A meta-analysis. Gastroenterol Hepatol 2023;46:309–318.CrossRefPubMed Huang J, Liu Y, Liu Y. Antiviral therapy in hepatitis B virus-infected with immune-tolerant: A meta-analysis. Gastroenterol Hepatol 2023;46:309–318.CrossRefPubMed
16.
Zurück zum Zitat Zhu Y, Wang J, Wang M, Zhou X, Zhang S, Zhang S et al. The Comparison of tenofovir alafenamide fumarate with tenofovir disoproxil fumarate in preventing hepatitis B transmission in mothers with high viral load: a retrospective cohort study. Journal of Hepatology 2022;77:S272.CrossRef Zhu Y, Wang J, Wang M, Zhou X, Zhang S, Zhang S et al. The Comparison of tenofovir alafenamide fumarate with tenofovir disoproxil fumarate in preventing hepatitis B transmission in mothers with high viral load: a retrospective cohort study. Journal of Hepatology 2022;77:S272.CrossRef
17.
Zurück zum Zitat Li BJ, Liu ZZ, Liu X, Liu DC, Duan MY, Gu Y et al. Efficacy and safety of tenofovir disoproxil fumarate and tenofovir alafenamide fumarate in preventing HBV vertical transmission of high maternal viral load. Hepatology International 2021;15:1103–1108.CrossRefPubMed Li BJ, Liu ZZ, Liu X, Liu DC, Duan MY, Gu Y et al. Efficacy and safety of tenofovir disoproxil fumarate and tenofovir alafenamide fumarate in preventing HBV vertical transmission of high maternal viral load. Hepatology International 2021;15:1103–1108.CrossRefPubMed
18.
Zurück zum Zitat YU Haiping YH. Observation on the Effect of Propofol Tenofovir Combined with Hepatitis Bimmunoglobulin on Blocking Mother-infant Transmission of Pregnant Women with High Load of Hepatitis B Virus. Drugs and Clinic 2020; 17: 47-49,62. YU Haiping YH. Observation on the Effect of Propofol Tenofovir Combined with Hepatitis Bimmunoglobulin on Blocking Mother-infant Transmission of Pregnant Women with High Load of Hepatitis B Virus. Drugs and Clinic 2020; 17: 47-49,62.
19.
Zurück zum Zitat Chinese Society of Hepatology CMA. Expert opinion on expanding anti-HBV treatment for chronic hepatitis B. Zhonghua Gan Zang Bing Za Zhi 2022;30:131–136. Chinese Society of Hepatology CMA. Expert opinion on expanding anti-HBV treatment for chronic hepatitis B. Zhonghua Gan Zang Bing Za Zhi 2022;30:131–136.
20.
Zurück zum Zitat Li Z, Xie B, Yi N Cai H, Yi W, Gao X. Efficacy and safety of tenofovir disoproxil fumarate or telbivudine used throughout pregnancy for the prevention of mother-to-child transmission of hepatitis B virus: A cohort study. Eur J Obstet Gynecol Reprod Biol 2022; 276: 102–106. Li Z, Xie B, Yi N Cai H, Yi W, Gao X. Efficacy and safety of tenofovir disoproxil fumarate or telbivudine used throughout pregnancy for the prevention of mother-to-child transmission of hepatitis B virus: A cohort study. Eur J Obstet Gynecol Reprod Biol 2022; 276: 102–106.
21.
Zurück zum Zitat Zeleke ED, Assefa DG, Joseph M, Bekele D, Tesfahunei HA, Getachew E et al. Tenofovir disoproxil fumarate for prevention of mother-to-child transmission of hepatitis B virus: A systematic review and meta-analysis of randomised control trials. Rev Med Virol 2021;31:1–16.CrossRefPubMed Zeleke ED, Assefa DG, Joseph M, Bekele D, Tesfahunei HA, Getachew E et al. Tenofovir disoproxil fumarate for prevention of mother-to-child transmission of hepatitis B virus: A systematic review and meta-analysis of randomised control trials. Rev Med Virol 2021;31:1–16.CrossRefPubMed
22.
Zurück zum Zitat Nishijima T, Kurosawa T, Tanaka, Kawasaki Y, Kikuchi Y, Oka S N et al. Urinary β2 microglobulin can predict tenofovir disoproxil fumarate-related renal dysfunction in HIV-1-infected patients who initiate tenofovir disoproxil fumarate-containing antiretroviral therapy. Aids 2016; 30: 1563–1571. Nishijima T, Kurosawa T, Tanaka, Kawasaki Y, Kikuchi Y, Oka S N et al. Urinary β2 microglobulin can predict tenofovir disoproxil fumarate-related renal dysfunction in HIV-1-infected patients who initiate tenofovir disoproxil fumarate-containing antiretroviral therapy. Aids 2016; 30: 1563–1571.
23.
Zurück zum Zitat Atef M, Zayed N, Salama R, Abdel Alem S, Yousof H, Saber M et al. Is urinary β2-microglobulin a reliable marker for assessment of renal tubular dysfunction in chronic hepatitis B patients receiving tenofovir therapy? Eur J Gastroenterol Hepatol 2021;33:e992–e998.CrossRefPubMed Atef M, Zayed N, Salama R, Abdel Alem S, Yousof H, Saber M et al. Is urinary β2-microglobulin a reliable marker for assessment of renal tubular dysfunction in chronic hepatitis B patients receiving tenofovir therapy? Eur J Gastroenterol Hepatol 2021;33:e992–e998.CrossRefPubMed
Metadaten
Titel
Effectiveness and Safety of Tenofovir Alafenamide Fumarate in the Prevention of Perinatal Hepatitis B Transmission: A Meta-Analysis
verfasst von
Ji Huang
Cong Cheng
Kangxin Li
Chunping Zhu
Youshun Liu
Publikationsdatum
10.02.2024
Verlag
Springer US
Erschienen in
Digestive Diseases and Sciences / Ausgabe 3/2024
Print ISSN: 0163-2116
Elektronische ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-023-08258-9

Weitere Artikel der Ausgabe 3/2024

Digestive Diseases and Sciences 3/2024 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.