Pregnancy and breastfeeding while on Tenofovir (Viread)

Hi everyone,

I would like to share my Tenofovir experience with the HBV community.

I am an HBV (Hbe Neg) carrier and have been on Tenofovir (Viread) since December 2009. Dr evaluated me and said that I had to start treatment even though viral load wasn't very high 59000UI/ml, AST and ALT in normal range according to old standards (ALT = 32 was the maximum I reached) and Liver Biopsy came back with stage 1. The new recommendations were to start treating at a low viral load.

When I first started, I was panicked because some references tell you not to get pregnant while on Viread because the drung might possibly harm baby's bones and some other stuff...Dr said it was ok to get pregnant and that Viread is a Category B drug which is safe during pregnancy. It has also been safely used by many HIV women since years.

I gave birth to my baby boy on December 16 2010 and and baby is doing just fine. If some of you ladies are on Tnf treatment, it is ok to get pregnant when you take Tenofovir. By the way, I never missed a pill since I started the treatment and during all my pregnancy. Tnf made the viral load undetectable starting from month 3 so the theory is baby has very low chances to get HBV. I am crossing my fingers!

After baby's birth, he has been given the HBV vaccine and immunoglobulin in the first 12 hours of his life and he will get the next vaccine shots for HBV at 1 month and 6 months of life. We will do a blood test at 7 month to make sure he didn't get the HBV virus during pregnancy or labor and delivery!! It is well know that ALT gets higher during pregnancy, mine went up from 21 to 32 during pregnancy, nothing crazy though...I will watch this starting from January to follow up on my ALT values. I didn't have any common problem during pregnany (high pressure, gestational diabetes...) thanks God.

As far as breastfeeding, opinions are contradictory...A first doctor said better avoid breastfeeding as there are not enough stdies on humans showing if tnf goes into the maternal milk and if can harm the baby. Another doctor said it is probably safe, the main concern was tnf not HBV as the virus doesn't go into maternal milk. The only study was done on maccaques and the study mentions that only 2% of tnf goes to breast milk and does not harm the baby. I also heard from other medhelp mothers that they have been told by their doctor that breastfeeding was safe while on Viread, I raised the issue during my delivery stay at the hospital and the consensus was, we will check baby's levels of creatinine and phosphate at birth and after 1 month of breastfeeding, if the values are stable, I can continue breastfeeding, if they get lower, they there might be some effect of baby's kidneys and I will have to add formula when feeding my baby. I am already using both methods breastfeeding and formula to lower the impacts if there are any. The argument is that tnf remains in our blood for 17 hours and that is a very long period.
I will  update whenever I get results for my baby's kidneys tests and HBV test at 7 months of life.

I hope this post benefits other HBV moms on Tenofovir treatment and who are trying to concieve (conceive). Good luck!

[almaja]

Thank you for shering your  expiriance.

[stef2011]

thank you for your post

is there a feature on this forum to keep important posts always first?

i think this post, alinia post, interferon+lam hbv eradication post, drugs that make resistance and maybe some other posts need to be always present otherwise they get lost among other posts less helpful or important

[enolia]

Thanks stefano. I don't know if there is any way to have specific posts first. I believe only the forum admin can set this up like welcome messages.

[chanthou]

Thanks so much for this important post. I'd love to see your next results.  This is the issue that I would like to know. My doctor said he would not experiment this until there is clear guideline about it. I plan to have a baby too. I'm on Viread since August.

[Aimee2050]

Thanks for the info. I too breastfeeding right now and baby just took the 2nd hepb shot. I pray to god all the time that he will not get it!!

[lilly993]

Very nice,thanks for the post.I too was diagnosed with heb b and is ready to have a baby with my husband before this gets too serious and before i start any medications. So am very happy reading your post,it makes me feel like i have a chance to have a family.Thank you Enolia and happy new yr to u and your family......

[enolia]

You are very welcome. I hope this helps. Happy new year to all!
I will update as soon as I have the next results.

[enolia]

Hi all

Update about Viread vs breastfeeding.
My baby's phosphate and creatinine test results came back normal so it is fine to breasfeed, I guess this means that baby's kidneys functions are not altered by Tenofovir, I was told if the results came back normal after one month of breastfeeding then I can continue otherwise I should mix both Formula and breastfeeding which I was doing anyways since he was born. Thanks god, these are good news!
I believe each baby needs to be tested to see how they react to the drug before using breastfeeding exlusively.

[lhllove]

Thank you so much for you post. I am 20 weeks pregnant and taking Tenofovir. Blood work looks good and liver ultrasound looks good. I would love to breastfeed my baby but my specialist and several doctors have told me NO.  I am devastated but reading your post has given me hope.  Will you update your son's progress.

[enolia]

Update on my baby's condition regarding HBV transmission:

Blood test after the HBV 3 vaccine shots came out normal! I am so happy! He doesn't have HBV and has acquired immunity 268 UI per ml in the antibodies count!

So my baby didn't get any HBV from me.

As a reminder:

- I am a chronic carrier with Hbe Neg,
- My original  pre-treatment DNA count was 59 000 UI per ml. ALT values were around 32 when I started treatment and are now around 20.
- I was undetectable throughout all my pregnancy after taking Tenofovir. I started Tnf before getting pregnant. That was my doctor's recommendation.
- I had a normal delivery (not ceasarian),
- After a lots of discussion, I have been told at the hospital after delivery that it was fine for me to breastfeed baby while on Tnf unless tests show harm to his kidney function (check levels of creatinine and phosphate) after 1 month of life to ensure he is not affected. I am still on Tnf and still breasfeeding. He is now 7.5 months old.

I thought I would share the good news :)
Thank God.

[stef2011]

i am very happy for this

also the fact to prevent any hbv entering the baby is very valuable because liver cancer rates are statistically the lowest among those that never met hbv while acute hbv who cleared have some increased risk although we are talking of very smll numbers

[enolia]

Hi Stef

Yes it was very important to us make sure the baby is HBV free. I believe I got it from my mom and my mom from her mom, etc. It was time the break this terrible chain, at least from my side! I feel so relieved!

[vijik]

congratulations! Take very care of your son.

[anmocchau]

Hi Enolia and hlllove

are you suffering from any side effects from taking Viread. I did some study about the side effects of Viread and they are quite severe (damage to liver and kidney).

Appreciate your feedback. I am thinking of taking Viread to reduce the risk for my little one. I am desparate.