The purpose of this study is to evaluate the pharmacokinetics, efficacy and safety of TAF in HBV-infected pregnant women.
Pregnant women with high viral load (HBV DNA\>2 × 10\^5 IU/mL ) are recommended to be given Tenofovir Disoproxil Fumarate(TDF) for mother-to-child blocking of Chronic hepatitis B(CHB) by guidelines. Tenofovir alafenamide (TAF) is a new targeted pro-drug of Tenofovir (TFV) and was approved for use in China in December 2018. Compared with TDF, the therapeutic dose of TAF is small. 25mg TAF can obtain the antiviral effect similar to 300mg TDF, thus reducing the concentration of TFV in the blood. This is a prospective clinical study, aiming to evaluate the pharmacokinetics, efficacy and safety of TAF in HBV-infected pregnant women when used for prevention of mother-to-child transmission of hepatitis B virus. 50 HBeAg-positive and HBV DNA levels ≥ 2 × 10\^5 IU/mL pregnant women will be enrolled to receive Tenofovir alafenamide (TAF) from week 28-32 of gestation until delivery. According to the mother's wishes, intensive blood samples will be collected to determine the concentration of TAF and TFV in plasma of pregnant women before and after taking TAF, calculate the pharmacokinetic parameters. And the mother's milk is collected every day for 5 days for TAF concentration determination. The primary endpoint was the pharmacokinetic parameters of TAF and TFV, rate of mother-to-child transmission, the congenital malformation rate of infants. The secondary endpoint was the decrease of HBV DNA level at delivery, the clearance and seroconversion rate of HBeAg, postpartum ALT flare, concentration of TAF and TFV in milk,and other adverse events of mothers and infants.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
50
Take 25mg TAF daily from week 28-32 of gestation until delivery
Hangzhou First People's Hospital
Hangzhou, Zhejiang, China
RECRUITINGAssessment on the pharmacokinetics of TAF and TFV in plasma of pregnant women
When taking the last TAF before delivery , 2ml of drug-containing blood was collected from the upper extremity veins at 0, 0.25, 0.5, 1, 1.5, 2, 2.5, 3, 4, 6, 8, 12 and 24h after taking TAF. Blood drug concentration at each time point was calculated according to standard curve.
Time frame: The day before delivery
Rate of mother-to-child transmission of HBV
Testing for HBsAg in the infants between 7 and 12 months of age.
Time frame: During 7-12 months after birth
Rate of birth defect of infants
The proportion of infants with the aforementioned abnormalities discovered during the study period
Time frame: From the date of birth to age of 28 weeks
Reduction of HBV DNA levels at delivery
Reduction of HBV DNA levels (IU/mL) at delivery when compared to the baseline before initiating TAF
Time frame: At delivery
Drug concentration of TAF and TFV in breast milk after drug withdrawal
Postpartum breast milk was collected to measure TAF and TFV concentrations after drug withdrawal
Time frame: Immediately after breast milk is available and last for 5 days
Concentrations of TAF and TFV in infant urine and plantar blood
Collect infant urine and plantar blood within 72 hours of birth
Time frame: Within 72 hours of birth
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