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