Efficacy and safety of telbivudine during pregnancy in a patient with HBeAg-Negative chronic Hepatitis B

Managing chronic hepatitis B (CHB) during pregnancy remains a challenging task as there is no information on the consequences to the fetus. Telbivudine, an oral nucleoside analog (NA), is a potential therapeutic option during pregnancy, but clinical experience is lacking. We report on the safety and efficacy of telbivudine 600 mg/day administered to a 20-year-old Indian woman with hepatitis B e antigen negative CHB, who became pregnant during treatment. Telbivudine was continued with monitoring of maternal hepatitis B virus (HBV) DNA and alanine aminotransferase (ALT) levels during pregnancy and after delivery. The patient maintained polymerase chain reaction (PCR) undetectable HBV DNA and normal ALT levels with telbivudine throughout pregnancy. At birth, HBV DNA was undetectable by PCR in the newborn. No congenital abnormalities were noted. In conclusion, telbivudine therapy during pregnancy was effective in maintaining undetectable viremia, and no safety concerns were noted in the mother and child. Additional clinical studies are warranted.