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Long-term safety of infants from mothers with chronic hepatitis B treated with tenofovir disoproxil in China


Objective The physical and neuromental development of infants remains uncertain after fetal exposure to tenofovir disoproxil fumarate (TDF) for the prevention of mother-to-child transmission of HBV. We aimed to investigate the safety of TDF therapy during the third trimester of pregnancy.

Design Infants from a previous randomised controlled trial were recruited for our long-term follow-up (LTFU) study. Mothers with chronic hepatitis B were randomised to receive TDF therapy or no treatment during the third trimester. Infants’ physical growth or malformation, bone mineral density (BMD) and neurodevelopment, as assessed using Bayley-III assessment, were examined at 192 weeks of age.

Results Of 180 eligible infants, 176/180 (98%) were enrolled and 145/176 (82%) completed the LTFU (control group: 75; TDF-treated group: 70). In the TDF-treated group, the mean duration of fetal exposure to TDF was 8.57±0.53 weeks. Congenital malformation rates were similar between the two groups at week 192. The mean body weight of boys in the control and TDF-treated groups was significantly higher (19.84±3.46 kg vs. 18.47±2.34 kg; p=0.03) and within the normal range (18.48±2.35 kg vs. 17.80±2.50 kg; p=0.07), respectively, when compared with the national standard. Other prespecified outcomes (head circumference, height, BMD, and cognitive, motor, social–emotional, and adaptive behaviour measurements) were all comparable between the groups.

Conclusion Infants with fetal exposure to TDF had normal physical growth, BMD and neurodevelopment at week 192. Our findings provide evidence on the long-term safety of infants after fetal exposure to maternal TDF therapy for preventing hepatitis B transmission.

Trial registration number NCT01488526.

  • hepatitis B
  • antiviral therapy
  • drug toxicity

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information. The data supporting the findings of this study are available from the corresponding author. Anonymized Individual Patient Data (IPD) may be shared with other qualified researchers upon request.A proposal with a detailed description of study objectives and a statistical analysis plan will be needed for evaluation of the reasonability to request for our data.Approval of such requests is at investigators' discretion and is dependent on the nature of the request, the merit of the research proposed, the availability of the data, and the intended use of the data. Data requests should be sent to the corresponding author. Data sharing much be approved by the authorities including the institutional review board and National Health Administrations in China.

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