Treatment during Pregnancy

[superstar11]

Hello All,

Forgive me if I'm posting this incorrectly.  This is my first time.  Unfortunately, I found out after I got pregnant that I am HBV positive. I am told that I have chronic HBV and probably got it from my mother. All of this is very new and scary to me, especially because I'm pregnant.  I recently went to a liver specialist and she told me that my viral load is very high and my ALT is also high. She did some additional bloodwork and she suggested that the next time we meet we talk about taking medication, possibly in the 2nd trimester to lower the viral load and hence lower the chances of infection to my child in addition to the 2 shots that will be given at birth. I am so scared. I can't find a lot of information online on treatment during pregnancy, but she told me there has been studies and it's safe. The other thing that I'm scared about is breastfeeding after giving birth. I am told that it is okay to breastfeed even if you are HBV positive. My concern is this; I did some research and found that it is not good to stop medication, which is what I thought I would do after giving birth so that I can breastfeed. From what I can tell, I will probably be taking lamivudine.  Will the medication that I will take during pregnancy harm my baby while I am breastfeeding if it is determined that I need to continue it for my own good? I found only one place online that even mentioned this and they said not to take it during breastfeeding. Please help! I am terrified and I don't really want to be a statistic because my doctor thinks it might be okay. I would like to know if anyone else has any input in this area or where I might find information. Thank you.  I am so terrified right now, I can barely sleep.  It's my baby that I am mostly concerned about.  I am afraid that if I don't go with the treatment, my baby will have a higher chance of contracting chronic hbv and if I do go on treatment, I am afraid of any birth defects.  Either way just stinks.  I don't know what to do.

[stef2011]

http://www.medhelp.org/personal_pages/user/1191262?personal_page_id=873530

contact this member, enolia, she successfully had the baby without hbv after vaccine and tenofovir during pregnancy

[makimak]

Hi, you would have had your baby by now, can you tell me what has happened since your last post as I am going thru the same thing?

[superstar11]

Thank you for your reply.  The information was very helpful.  I would not have known where to look.  The doctor actually didn't say anything about the drug.  I just got the name from reading online materials about pregnancy and what has been prescribed.  Maybe what I am reading is not current.  I just assumed it's what would be prescribed.  I will however keep tenofovir in mind once I meet with the doctor again in a week and a half.  I will post again then.  Again, thank you for your quick response.  It is very much appreciated.

[Sharp7]

almost forgot: when you get around to it, you can also read http://www.medhelp.org/health_pages/Hepatitis/HepB-Introduction--Welcome-Page/show/34?cid=153

[Sharp7]

strange... you are in the US, and you still have doctors prescribing lamivudine to you! I mention this first because these days, I find that in most cases, doctors prescribing it should be immediately be put under probation! Yes... I have seen these warnings about use of lamivudine by breast-feeding mothers. More importantly, lamivudine is one of the earliest drugs for Hep B, and the one that Hep B viruses adapt to most easily. If the viruses develop resistance, even some of the most potent drugs lose their potency. If I were in your place, I would go for a second (third or even fourth) opinion until I find a doctor who seems to be aware of the field. What was this doctor's reason for recommending lamivudine? Did the doctor really say "lamivudine"? I am not sure, from the way you write. Probably the only good thing about LAM is that it is old and cheap, except that in the US, several manufacturers of more potent medicine often give medicines for free, if you contact them, and explain your situation.

Anyway, tenofovir is the recommended drug for pregnant women these days. Read these:
http://www.hivandhepatitis.com/2009icr/icaac/docs/091509_d.html
http://www.hivandhepatitis.com/recent/2009/032409_b.html

You are right: once you begin medication, it is not good to stop.

Do let us know what your test reports say. Though I understand most readings in most people, I dare not say very much readings in pregnant women. Hopefully some other forum members (who have given birth to kids) will comment.

Easy for me to say, I'm a bloke... but don't be terrified. Relax :-). As you can see from the articles above, (and as I know from some forum members lives) it is perfectly safe to give birth despite Hep B.