University of California San Francisco, UCSF, Department of Medicine.
Columbia University, Medicine.
University of Michigan.
Tufts Medical Center, Division of Clinical Decision Making Hwang, Jessica.
Philadelphia VAMC & University of Pennsylvania, Medical Research Bzowej, Natalie.
Children's Hospital Boson, Division of Gastroenterology, Hepatology and Nutrition.
Alaska Native Tribal Health Consortium, Liver Disease and Hepatitis.
Prevention of mother-to-child transmission of hepatitis B virus (HBV) is a major component of the HBV elimination efforts in every country. We thank Drs. Mubarak and Ferstenberg for highlighting the AASLD2018 Updated Hepatitis B Guidance on prevention of mother-to-child transmission 1 and conclusions from a recently published randomized clinical trial by Jourdain et al. of tenofovir disoproxil fumarate (TDF) versus placebo in pregnancy2 . In the Jourdain et al. study, TDF was not associated with a statistically significant reduction in perinatal transmission of HBV, but the 2% rate of perinatal transmission with placebo was much lower than the expected 12%, leaving the study underpowered to detect a statistically significant difference. Notably, no infants became infected in the TDF treated group, similar to another randomized trial comparing third trimester TDF to placebo.