Efficacy and safety of lamivudine treatment in late pregnancy with high HBV DNA: a perspective for mother and infants.

INTRODUCTION Perinatal transmission - from mother to fetus - is one of the main transmission routes of chronic hepatitis B (CHB) infection. Lamivudine therapy has been reported to prevent the replication of hepatitis B virus (HBV) in pregnant women with a high viral load that can lead to perinatal transmission. METHODOLOGY This study sought to evaluate retrospectively the efficacy and safety of lamivudine treatment in pregnant women with CHB and a high viral load. Biochemical parameters, and virological and serological responses at the 32nd and 36th week of gestation and after labor were recorded. The complications of CHB and the adverse effects of lamivudine treatment were also recorded. RESULTS Following 8 weeks of lamivudine treatment, HBV viral load decreased to levels ≤ 10,000 copies/ml in five of the seven patients (71%) and in three patients (43%), HBV DNA was found to be completely negative after labor. Neither adverse effects caused by lamivudine treatment nor complications due to CHB infection were experienced by mothers or infants. CONCLUSIONS The results of this study suggest that lamivudine therapy in highly viremic hepatitis B surface antigen (HBsAg)-positive pregnant women could decrease perinatal transmission rates of HBV, and can lower the HBV viral load during labor.