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Tenofovir Disoproxil Fumarate Prenatal as A Complementary Treatment to Prevent Vertical Transmission of Hepatitis B Virus: A Systematic Review

Bagus Setyoboedi, Avianita Dewi Kusumawardhani, Agung Dwi Wahyu Widodo, Muhammad Ilham Aldika Akbar.

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Vertical transmission is the dominant transmission method in hepatitis B endemic countries. Immunoprophylactic protocols leave 1% to 4% of infants with a higher risk of immunoprophylactic failure. Within the last ten years, publications regarding the use of prenatal Tenofovir disoproxil fumarate (TDF) have been continuously updated. TDF is preferred because of its potency and lower risk of resistance than lamivudine and telbivudine. The studies analyzed in this systematic review consisted of 2 RCT and 7 NRCT studies, involving 3,765 participants. Six studies described a reduction in viral load HBV DNA levels in the intervention group. Furthermore, five studies reported a decrease in the vertical transmission rate higher than the control group, proven with positive HBsAg parameters at newborns in the intervention group. All studies in this systematic review show a reduced risk of immunoprophylactic failure in the intervention group, proven with negative HBsAg and anti-HBs status when infants were 6-12 months old. There were no significant differences between the intervention and control groups in all studies from a safety point of view. Administration of prenatal TDF and the prophylactic protocol can reduce the vertical transmission rate and the risk of immunoprophylactic failure without causing significant adverse effects both during pregnancy and in infants. Given the consideration, the public health sector and physicians should consider TDF prenatal as a complementary treatment to prevent vertical transmission.

Key words: Hepatitis B, Tenofovir disoproxil fumarate, Vertical transmission

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