Efficacy of Tenofovir Disoproxil on Mother-to-child Transmission of HBV in Tokombéré, Cameroon in Pregnant Women (TOPCHIB)

Efficacy of Tenofovir Disoproxil on Mother-to-child Transmission of HBV in Tokombéré, Cameroon in Pregnant Women Infected With Hepatitis B Virus (HBeAg Positive or With a High Viral Load) and Whose Newborns Had Been Vaccinated at Birth

Pregnant women with HBeAg-positive viral hepatitis b or high viral load will receive Tenofovir disoproxil fumarate (TDF) from the 28th week of amenorrhoea until 6 weeks after delivery. Their newborns will receive the hepatitis B vaccine, starting with one dose at birth and followed by three booster doses, according to the Expanded Programme on Immunisation.

The investigators hypothesise that a short course of TDF could greatly reduce the risk of HBV MTCT in pregnant women at high risk of MTCT (HBeAg positive or with high viral load).

Study Overview

• Status: Recruiting
• Conditions: Hepatitis B Virus - Chronic Active
• Intervention / Treatment: Drug: Fumarate, Tenofovir Disoproxil

Detailed Description

This is a prospective, single-arm, open-label, descriptive, phase IV clinical trial in HBsAg and HBeAg positive pregnant women. Eligible pregnant women will receive 245 mg of tenofovir disoproxil fumarate once daily from 28 weeks of pregnancy until 6 weeks after delivery. Newborns will receive the hepatitis B vaccine, starting with one dose at birth, followed by three booster doses, in accordance with the expanded programme of vaccination.

The study aims to show that the addition of maternal antiviral treatment to vaccination at birth followed by three booster doses can be favourably considered in the context where vaccination alone is not sufficient to prevent transmission of the hepatitis B virus from mother to child. A total of 150 pregnant women will be included in the Tokombéré district.

• Study Type: Interventional
• Enrollment (Estimated): 150
• Phase: Phase 4

Contacts and Locations

• Study Contact: Name: Maaga DOURWE, MD; Phone Number: 0697073424; Email: dourwemaaga2@gmail.com

Study Locations

• Cameroon
  • Tokonbéré, Cameroon
    • Recruiting
    • Hôpital Privé de Tokombéré
    • Contact: Maaga DOURWE, MD

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 16 years and older (Child, Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion criteria:

• Pregnant women with a term of less than 24 weeks of amenorrhea;
• HBsAg positive ;
• HBeAg positive or HBeAg negative with a high viral load ( > 200 000 UI/ml) ;
• 16 years old or more on the inclusion day ;
• Signature of free and informed consent (for pregnant women aged 16 to 21, the participant's consent as well as the authorization of a parent/adult husband/ legal tutor will be collected) which also includes consent for the children

Exclusion criteria :

• HIV co-infection;
• Women treated for HBV;
• Creatinine clearance <30 ml / min;
• Suspicion of poor monitoring of children's vaccination schedule for HBV (vaccination at birth + boosters);
• Disease or treatment contraindicating the taking of TDF.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Other: pregnant woman - tenofovir; Participants will be started on tenofovir disoproxil fumarate (TDF) 245 mg one tablet per day from week 28 of pregnancy until 6 weeks postpartum.	Drug: Fumarate, Tenofovir Disoproxil; all participants receive the intervention; Other Names: TDF

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Proportion of children with HBsAg positive at 9-12 months of life (W36 - W48) in the study population,	Proportion of HBsAg-positive children between 9 and 12 months of age in the study population, assessed by an automated test (mini VIDAS)	measured between 36 and 48 weeks of life of the child of the mothers included in the study

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Proportion of eligible women who accepted the intervention among eligible women offered the intervention (acceptance rate)	Proportion of women who took TDF continuously from the 7th month of pregnancy to 8 weeks postpartum (for at least 4 months) among women who accepted the intervention	measured from 7 months of pregnancy to 8 weeks postpartum
Compliance with treatment	Compliance with treatment, estimated by self-report questionnaire and pill count	from 28 weeks of pregnancy to 8 weeks postpartum
Progression of viral load	Progression of viral load, HBsAg, HBeAg, HBcr and anti-HBe seroconversion in pregnant women during the treatment period (measured at inclusion and at the end of the TDF treatment)	measured from 24 weeks of pregnancy until the end of treatment
Estimate the protection rate of children with anti-HBs antibody level > 10 mIU/mL	Proportion of children with anti-HBs Ac > 10 mIU/ml at 9-12 months / total number of children in the study.	measured between 36 and 48 weeks of life of the child of the mothers included in the study
Assess the clinical and biological tolerance of TDF administration in mothers and children	Nature, number, frequency and intensity of adverse events in women; Nature, number, frequency, and intensity of adverse events in mothers and children and whether they are related to TDF use	measured from 28 weeks of pregnancy until the end of treatment
Assess the rate of women requiring extended treatment after delivery	Proportion of cytolytic or virological rebounds (with detectable viral load) after cessation of treatment estimated by measurement of ALT and HBV viral load at 12 weeks and 24 weeks postpartum when they previously had a non-detectable viral load at 8 weeks postpartum	Assess at 12 and 24 weeks postpartum
To assess the cost-effectiveness of the intervention (compared to vaccination alone, without hepatitis B immune globulin (Ig-anti HBV))	Incremental cost-effectiveness ratio of the intervention compared to the situation where children receive vaccination only (HBV vaccination at birth + pentavalent)	To evaluate throughout the study

Collaborators and Investigators

• Sponsor: ANRS, Emerging Infectious Diseases
• Investigators: Principal Investigator: Jean-Pierre ADOUKARA, MD, Hôpital de Tokombéré

Study record dates

Study Major Dates

• Study Start (Actual): August 22, 2023
• Primary Completion (Estimated): August 1, 2027
• Study Completion (Estimated): February 1, 2028

Study Registration Dates

• First Submitted: May 23, 2022
• First Submitted That Met QC Criteria: May 28, 2022
• First Posted (Actual): June 3, 2022

Study Record Updates

• Last Update Posted (Actual): June 29, 2026
• Last Update Submitted That Met QC Criteria: June 25, 2026
• Last Verified: June 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Digestive System Diseases; Virus Diseases; Infections; Blood-Borne Infections; Communicable Diseases; Liver Diseases; Hepatitis, Viral, Human; Hepadnaviridae Infections; DNA Virus Infections; Hepatitis B; Hepatitis; Organic Chemicals; Heterocyclic Compounds; Heterocyclic Compounds, 2-Ring; Heterocyclic Compounds, Fused-Ring; Purines; Organophosphorus Compounds; Organophosphonates; Adenine; Tenofovir
• Other Study ID Numbers: ANRS 12417 TOPCHIB

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: Yes