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Entecavir is Effective in Preventing Hepatitis B Reactivation in Cancer Patients Receiving Chemotherapy
Su1001
of the patients were born outside of the United States. 57% of the patients born outside of the US had been in the US less than 10 years. More than 79% of the patients had at least a college degree. Average number of pregnancies was 2. Average week of gestation was 29 weeks. 67% of respondents (95% CI 55% to 79%) reported they would take hepatitis B medication while pregnant. 100% of the respondents planned on breastfeeding, but 58% (95% CI 46 to 70%) stated they would not breastfeed if they knew they had hepatitis B. Over 97% stated their reason was that they would be afraid to transmit hepatitis B to their baby. Conclusion: Most women were interested in taking antiviral therapy for hepatitis B while pregnant, likely motivated by a desire to reduce perinatal transmission. Patients still perceive a high risk of HBV transmission via breastfeeding despite current recommendations further supporting the need for patient education.
AASLD Abstracts
On-Treatment HBsAg Level Can Early Predict Sustained Virological Response in Chronic Hepatitis B, HBeAg Negative Patients Treated With Peginterferon ALPHA-2A Pochamana Phisalprapa, Phunchai Charatcharoenwitthaya, Siwaporn P. Chainuvati, Supot Nimanong, Nonthalee Pausawasdi, Varayu Prachayakul, Supot Pongprasobchai, Somchai Leelakusolvong, Sataporn Manatsathit, Udom Kachintorn, Tawesak Tanwandee Background/Aims: Treatment with peginterferon alpha-2a (PEG-IFN) in chronic hepatitis B, HBeAg negative patients can suppress viral replication in only 19% at 24 weeks posttreatment. Many predictors including baseline ALT, HBV DNA and liver histology have been proposed as predictors of sustained viral suppression (SV) but none of these are strong enough to be used as on-treatment decision. Recently, HBsAg has been proposed as an important on-treatment predictor. This study aimed to evaluate the usefulness of HBsAg level during treatment as early predictors of SV. Methods: Chronic hepatitis B, HBeAg negative patients were enrolled to receive PEG-IFN 180 mcg/week for 48 weeks. Serum HBV DNA and HBsAg level were serially assessed at baseline and every 12 weeks until week 72. Treatment endpoints were undetectable HBV DNA and normal ALT at week 72 (SV). Results: There were 24 patients, mean age of 48 years and 67% were male. Mean baseline of log10 HBV DNA (IU/mL) and HBsAg (IU/mL) were 4.9 and 3.3, respectively. At week 48, there were 16 (67%) undetectable HBV DNA, however at week 72, there were only 7 (29%) patients that can achieve SV and 2 of them (8%) lost HBsAg. There was no different in baseline characteristic between responders and nonresponders. Responders had more rapid decline of HBsAg level at week 24 (0.8 log10 and 0.2 log10 (IU/mL), respectively, P = 0. 019). There were no different in on-treatment decline of HBV DNA in both groups. Decrease HBsAg level more than 0.33 log10 at week 24 has a high negative predictive value (NPV) and positive predictive value (PPV), 92% and 86%, respectively. HBsAg level at week 12 or week 24 of more than 1500 IU/mL had NPV of 100% and this can be used as stopping rule. Conclusions: This study suggests that on-treatment HBsAg level is useful to predict SV and superior than HBV DNA. HBsAg greater than 1500 IU/mL had NPV of 100% and can be used as early stopping rule.
Su1004 Peginterferon Alfa-2a in Japanese HBeAg-Positive Patients is Not Inferior to Conventional Interferon Therapy Norio Hayashi, Kendo Kiyosawa, Hirohito Tsubouchi, Takeshi Okanoue, Hiromitsu Kumada Background Although peginterferon alfa-2a [40KD] (PEG-IFN) is recommended by international guidelines as a first-line therapy for patients with CHB, it is not currently approved in Japan. We compared the efficacy and safety of PEG-IFN with interferon alfa (IFN) in HBeAg-positive Japanese patients. Methods In this randomized, non-inferiority study, HBeAg-positive Japanese patients received: 1. PEG-IFN (90μg/week for 24 weeks); 2. PEGIFN (180μg/week for 24 weeks); 3. PEG-IFN (90μg/week for 48 weeks); 4. PEG-IFN (180μg/ week for 48 weeks); 5. IFN (6MIU 3x/week for 24 weeks). The primary objective was to assess whether PEG-IFN for 24 or 48 weeks (90 and 180μg doses combined) is not inferior to IFN. The primary endpoint was triple response (HBeAg seroconversion, HBV DNA <5 log copies/mL and ALT normalization) 24 weeks post-treatment. The non-inferiority margin was pre-specified as >-7% of the lower limit of the 95% CI of the difference between treatment responses. The analysis also compared the 90 and 180μg doses (24 weeks and 48 weeks combined) of PEG-IFN with IFN. Results Of the 215 randomized patients, 207 patients (51-67% male) were included in the ITT analysis. Baseline characteristics were similar in all groups: mean age 32-35 years; mean HBV DNA 7.3-7.5 log copies/mL; mean ALT 139-172 U/L. Almost all patients were infected with genotype C (95-98%). Triple response rate 24 weeks post-treatment was 18.3% (15/82; CI:10.6, 28.4) in the 48-week treatment group compared with 7.3% (6/82; CI:2.7, 15.2) in the 24-week group and 7.0% (3/43; CI:1.5, 19.1) for IFN. Compared with IFN, the differences in treatment response for the 48- and 24-week PEG-IFN groups were 11.3% (CI:0.0, 22.6) and 0.3% (CI:-9.1, 9.8), respectively. Triple response rate 24 weeks post-treatment was 14.6% (12/82; CI:7.8, 24.2) in the 180μg group and 11.0% (9/82; CI:5.1, 19.8) in the 90 μg group. Compared with IFN, the differences in response for the 180μg and 90μg groups were 7.7% (CI:-3.1, 18.5) and 4.0% (CI:-6.2, 14.2), respectively. Two patients (1 in the 180/48 group and 1 in the 180/24 group) achieved HBsAg seroconversion. PEG-IFN and IFN were well tolerated. Conclusions The study met its primary objective by showing that PEG-IFN for 48 weeks was not inferior to IFN for 24 weeks. Compared with a shorter treatment duration, the highest response rates were achieved with 48 weeks of PEG-IFN. Similarly, compared with a lower dose, the highest response rates were achieved with the 180μg dose. This study indicates that the 180μg dose and 48 weeks duration of PEG-IFN is the most efficacious treatment regimen for HBeAg-positive Japanese patients predominantly infected with genotype C.
Su1002 Entecavir is Effective in Preventing Hepatitis B Reactivation in Cancer Patients Receiving Chemotherapy Robin B. Mendelsohn, Ying Taur, Garett Ng, Dhruv Patel, Mini Kamboj, Andrew D. Zelenetz, Kent Sepkowitz, Emmy Ludwig Background: Reactivation of hepatitis B virus (HBV) infection is a well-recognized complication of immunosuppression from chemotherapy and can lead to significant morbidity and mortality. Lamivudine has been shown in multiple trials to be effective in preventing reactivation, but the long term use of lamivudine is limited by the frequent development of lamivudine resistant HBV strains. A previous study in Asian lymphoma patients showed entecavir to be effective in preventing HBV reactivation. The aim of this study is to report the efficacy of entecavir in preventing HBV reactivation in a heterogeneous cancer population undergoing chemotherapy. Methods: We conducted a prospective study of all patients at Memorial Sloan-Kettering Cancer Center who began chemotherapy and were screened for HBV from January 2009 to April 2010. Patients were included if they were positive for hepatitis B surface antigen (HBsAg) with normal serum aminotransferases. Patients were excluded if they had co-infection with hepatitis C virus or human immunodeficiency virus, had prior treatment with antivirals, were initiated on an antiviral other than entecavir (at the discretion of the primary physician or because of patient preference), or had hepatocellular carcinoma. Entecavir 0.5mg oral dose daily was administered beginning at inception of therapy and ending 6 months after chemotherapy was completed. Patients were followed with serum aminotransferases and HBV DNA PCR levels every 3 months. Results: We identified 22 patients (median age 61 years old, 45% male) who were HbsAg positive. Of these, 50% were of Asian birth, 64% had solid tumors, 27% had lymphoma. During the treatment period, 3 (14%) had a rise in their transaminases (mean maximum ALT 127 Units/L), but none of the 3 had detectable HBV DNA at the time of the hepatitis. Two elevations were attributed to medications, 1 to liver metastases. No patients developed an elevation of their HBV DNA PCR. There were no delays in cancer treatment. No side effects or adverse drug interactions from the entecavir were reported. Conclusion: This is the first study to report the efficacy of using entecavir as first line medication for prophylaxis against HBV reactivation in a heterogeneous cancer population undergoing chemotherapy. We found no cases of HBV reactivation during our study period. Long term studies are needed to identify the optimal timing and duration of antiviral prophylaxis.
Su1005 Comparison of the Efficacy of Entecavir and Tenofovir in Chronic Hepatitis B Patients With High Viral Load and/or High Fibrosis Scores at Week 48 of Therapy Ayse O. Kurdas Ovunc, Fatih Guzelbulut, Ebubekir Senates, Yasemin Gökden, Ayca G. Degirmenci Salturk, Züleyha Akkan Çetinkaya, Mesut Sezikli, Selvinaz Ozkara, Fuat Çetinkaya Background and Aim: In clinical trials, entecavir (ETV) and tenofovir (TDF) have been shown to be potent inhibitors of hepatitis B virus (HBV). However, there is not any headto-head study comparing the efficacy of these 2 drugs. We aimed to compare the efficacy of entecavir and tenofovir in nucleos(t)ide-naive chronic hepatitis B (CHB) patients with high viral load and/or high fibrosis scores at week 48 of therapy in terms of virological, serological, biochemical, and histological responses. Methods: We retrospectively rewieved our data of CHB patients. Nucleos(t)ide-naive CHB patients who had received ETV or TDF for at least 48 weeks with the following criteria were included in the present study: 1) liver biopsy prior to and at the end of week 48 of therapy, 2) pretreatment fibrosis scores ≥3 (Ishak) with any serum HBV DNA levels or serum HBV DNA levels ≥ 6 log copy/mL with any fibrosis scores. We compared the efficacy of ETV and TDF at week 4, week 12, week 24 and week 48 of therapy in terms of declines in serum HBV DNA levels, undetectable HBV DNA levels, and normalization of serum ALT levels. In addition, change in fibrosis scores and HBeAg seroconversion rates (in HBeAg positive patients) were evaluated at week 48 of therapy. Results: Totally, 44 Caucasian patients were included in the present study. Twenty-four patients had received ETV and 20 had received TDF. There were not statistically significant differences between patients who had received ETV and those who had received TDF in terms of age, gender, body mass index, HBeAg status, serum HBV DNA levels, ALT levels, histological activity index (HAI), and fibrosis scores at the beginning of therapy (Table 1). Declines in serum HBV DNA levels, achievement of undetectable serum HBV DNA levels, and normalization of serum ALT levels were similar in patients who had received ETV and TDF at week 4, week 12, week 24 and week 48 of therapy. At week 48 of therapy, serum HBV DNA levels decreased by 6,93±1,54 log copy/mL in ETV group and 6,89±1,22 log copy/mL in TDF group (p=0,654). Twenty-one of 24 (87,5%) patients in ETV group and 19 of 20 (95%) patients in TDF group achieved undetectable HBV DNA levels at week 48 (p=0,389). Serum ALT levels were normalized in 19 of 24 (79,17%) patients in ETV group and in 17 of 20 (85%) patients in TDF group (p=0,617). HBeAg seroconversion was achieved in 1 of 5 patients in ETV group and in 3 of 6 patients in TDF group (p=0,303). Mean
Su1003 Pregnant Women and Their Willingness to Be Treated for Hepatitis B During Pregnancy Andrew Ho, Tram T. Tran Background: Perinatal transmission in women with chronic hepatitis B virus (HBV) has been greatly reduced by immunoprophylaxis with hepatitis B immune globulin (HBIG) and HBV vaccination series, with reported 95% effectiveness. In women with high maternal viremia, perinatal transmission has been reported at higher rates, even with vaccination. Some studies have shown antiviral therapy during the third trimester of pregnancy reduces viral load in the mother and possibly decreases the risk of perinatal transmission. Perceptions regarding antiviral therapy for HBV in pregnancy is largely unknown. Methods: A translated questionnaire was given to pregnant women in waiting rooms at various obstetrics/gynecology clinics. Clinics with a large Asian population were targeted because of the high incidence of hepatitis B in that group. The questionnaire obtained information on demographic characteristics, obstetric history, family history of HBV, and personal history of HBV, perceptions of treatment and risks, including breastfeeding. Results: Seventy five patients were asked to participate in the study; 60 completed questionnaires and comprised the study population. Mean age was 32 years old (range 21-44). Fifty-five respondents (91%) were of Asian ethnicity. 93%
AASLD Abstracts
S-930
of the patients were born outside of the United States. 57% of the patients born outside of the US had been in the US less than 10 years. More than 79% of the patients had at least a college degree. Average number of pregnancies was 2. Average week of gestation was 29 weeks. 67% of respondents (95% CI 55% to 79%) reported they would take hepatitis B medication while pregnant. 100% of the respondents planned on breastfeeding, but 58% (95% CI 46 to 70%) stated they would not breastfeed if they knew they had hepatitis B. Over 97% stated their reason was that they would be afraid to transmit hepatitis B to their baby. Conclusion: Most women were interested in taking antiviral therapy for hepatitis B while pregnant, likely motivated by a desire to reduce perinatal transmission. Patients still perceive a high risk of HBV transmission via breastfeeding despite current recommendations further supporting the need for patient education.
AASLD Abstracts
On-Treatment HBsAg Level Can Early Predict Sustained Virological Response in Chronic Hepatitis B, HBeAg Negative Patients Treated With Peginterferon ALPHA-2A Pochamana Phisalprapa, Phunchai Charatcharoenwitthaya, Siwaporn P. Chainuvati, Supot Nimanong, Nonthalee Pausawasdi, Varayu Prachayakul, Supot Pongprasobchai, Somchai Leelakusolvong, Sataporn Manatsathit, Udom Kachintorn, Tawesak Tanwandee Background/Aims: Treatment with peginterferon alpha-2a (PEG-IFN) in chronic hepatitis B, HBeAg negative patients can suppress viral replication in only 19% at 24 weeks posttreatment. Many predictors including baseline ALT, HBV DNA and liver histology have been proposed as predictors of sustained viral suppression (SV) but none of these are strong enough to be used as on-treatment decision. Recently, HBsAg has been proposed as an important on-treatment predictor. This study aimed to evaluate the usefulness of HBsAg level during treatment as early predictors of SV. Methods: Chronic hepatitis B, HBeAg negative patients were enrolled to receive PEG-IFN 180 mcg/week for 48 weeks. Serum HBV DNA and HBsAg level were serially assessed at baseline and every 12 weeks until week 72. Treatment endpoints were undetectable HBV DNA and normal ALT at week 72 (SV). Results: There were 24 patients, mean age of 48 years and 67% were male. Mean baseline of log10 HBV DNA (IU/mL) and HBsAg (IU/mL) were 4.9 and 3.3, respectively. At week 48, there were 16 (67%) undetectable HBV DNA, however at week 72, there were only 7 (29%) patients that can achieve SV and 2 of them (8%) lost HBsAg. There was no different in baseline characteristic between responders and nonresponders. Responders had more rapid decline of HBsAg level at week 24 (0.8 log10 and 0.2 log10 (IU/mL), respectively, P = 0. 019). There were no different in on-treatment decline of HBV DNA in both groups. Decrease HBsAg level more than 0.33 log10 at week 24 has a high negative predictive value (NPV) and positive predictive value (PPV), 92% and 86%, respectively. HBsAg level at week 12 or week 24 of more than 1500 IU/mL had NPV of 100% and this can be used as stopping rule. Conclusions: This study suggests that on-treatment HBsAg level is useful to predict SV and superior than HBV DNA. HBsAg greater than 1500 IU/mL had NPV of 100% and can be used as early stopping rule.
Su1004 Peginterferon Alfa-2a in Japanese HBeAg-Positive Patients is Not Inferior to Conventional Interferon Therapy Norio Hayashi, Kendo Kiyosawa, Hirohito Tsubouchi, Takeshi Okanoue, Hiromitsu Kumada Background Although peginterferon alfa-2a [40KD] (PEG-IFN) is recommended by international guidelines as a first-line therapy for patients with CHB, it is not currently approved in Japan. We compared the efficacy and safety of PEG-IFN with interferon alfa (IFN) in HBeAg-positive Japanese patients. Methods In this randomized, non-inferiority study, HBeAg-positive Japanese patients received: 1. PEG-IFN (90μg/week for 24 weeks); 2. PEGIFN (180μg/week for 24 weeks); 3. PEG-IFN (90μg/week for 48 weeks); 4. PEG-IFN (180μg/ week for 48 weeks); 5. IFN (6MIU 3x/week for 24 weeks). The primary objective was to assess whether PEG-IFN for 24 or 48 weeks (90 and 180μg doses combined) is not inferior to IFN. The primary endpoint was triple response (HBeAg seroconversion, HBV DNA <5 log copies/mL and ALT normalization) 24 weeks post-treatment. The non-inferiority margin was pre-specified as >-7% of the lower limit of the 95% CI of the difference between treatment responses. The analysis also compared the 90 and 180μg doses (24 weeks and 48 weeks combined) of PEG-IFN with IFN. Results Of the 215 randomized patients, 207 patients (51-67% male) were included in the ITT analysis. Baseline characteristics were similar in all groups: mean age 32-35 years; mean HBV DNA 7.3-7.5 log copies/mL; mean ALT 139-172 U/L. Almost all patients were infected with genotype C (95-98%). Triple response rate 24 weeks post-treatment was 18.3% (15/82; CI:10.6, 28.4) in the 48-week treatment group compared with 7.3% (6/82; CI:2.7, 15.2) in the 24-week group and 7.0% (3/43; CI:1.5, 19.1) for IFN. Compared with IFN, the differences in treatment response for the 48- and 24-week PEG-IFN groups were 11.3% (CI:0.0, 22.6) and 0.3% (CI:-9.1, 9.8), respectively. Triple response rate 24 weeks post-treatment was 14.6% (12/82; CI:7.8, 24.2) in the 180μg group and 11.0% (9/82; CI:5.1, 19.8) in the 90 μg group. Compared with IFN, the differences in response for the 180μg and 90μg groups were 7.7% (CI:-3.1, 18.5) and 4.0% (CI:-6.2, 14.2), respectively. Two patients (1 in the 180/48 group and 1 in the 180/24 group) achieved HBsAg seroconversion. PEG-IFN and IFN were well tolerated. Conclusions The study met its primary objective by showing that PEG-IFN for 48 weeks was not inferior to IFN for 24 weeks. Compared with a shorter treatment duration, the highest response rates were achieved with 48 weeks of PEG-IFN. Similarly, compared with a lower dose, the highest response rates were achieved with the 180μg dose. This study indicates that the 180μg dose and 48 weeks duration of PEG-IFN is the most efficacious treatment regimen for HBeAg-positive Japanese patients predominantly infected with genotype C.
Su1002 Entecavir is Effective in Preventing Hepatitis B Reactivation in Cancer Patients Receiving Chemotherapy Robin B. Mendelsohn, Ying Taur, Garett Ng, Dhruv Patel, Mini Kamboj, Andrew D. Zelenetz, Kent Sepkowitz, Emmy Ludwig Background: Reactivation of hepatitis B virus (HBV) infection is a well-recognized complication of immunosuppression from chemotherapy and can lead to significant morbidity and mortality. Lamivudine has been shown in multiple trials to be effective in preventing reactivation, but the long term use of lamivudine is limited by the frequent development of lamivudine resistant HBV strains. A previous study in Asian lymphoma patients showed entecavir to be effective in preventing HBV reactivation. The aim of this study is to report the efficacy of entecavir in preventing HBV reactivation in a heterogeneous cancer population undergoing chemotherapy. Methods: We conducted a prospective study of all patients at Memorial Sloan-Kettering Cancer Center who began chemotherapy and were screened for HBV from January 2009 to April 2010. Patients were included if they were positive for hepatitis B surface antigen (HBsAg) with normal serum aminotransferases. Patients were excluded if they had co-infection with hepatitis C virus or human immunodeficiency virus, had prior treatment with antivirals, were initiated on an antiviral other than entecavir (at the discretion of the primary physician or because of patient preference), or had hepatocellular carcinoma. Entecavir 0.5mg oral dose daily was administered beginning at inception of therapy and ending 6 months after chemotherapy was completed. Patients were followed with serum aminotransferases and HBV DNA PCR levels every 3 months. Results: We identified 22 patients (median age 61 years old, 45% male) who were HbsAg positive. Of these, 50% were of Asian birth, 64% had solid tumors, 27% had lymphoma. During the treatment period, 3 (14%) had a rise in their transaminases (mean maximum ALT 127 Units/L), but none of the 3 had detectable HBV DNA at the time of the hepatitis. Two elevations were attributed to medications, 1 to liver metastases. No patients developed an elevation of their HBV DNA PCR. There were no delays in cancer treatment. No side effects or adverse drug interactions from the entecavir were reported. Conclusion: This is the first study to report the efficacy of using entecavir as first line medication for prophylaxis against HBV reactivation in a heterogeneous cancer population undergoing chemotherapy. We found no cases of HBV reactivation during our study period. Long term studies are needed to identify the optimal timing and duration of antiviral prophylaxis.
Su1005 Comparison of the Efficacy of Entecavir and Tenofovir in Chronic Hepatitis B Patients With High Viral Load and/or High Fibrosis Scores at Week 48 of Therapy Ayse O. Kurdas Ovunc, Fatih Guzelbulut, Ebubekir Senates, Yasemin Gökden, Ayca G. Degirmenci Salturk, Züleyha Akkan Çetinkaya, Mesut Sezikli, Selvinaz Ozkara, Fuat Çetinkaya Background and Aim: In clinical trials, entecavir (ETV) and tenofovir (TDF) have been shown to be potent inhibitors of hepatitis B virus (HBV). However, there is not any headto-head study comparing the efficacy of these 2 drugs. We aimed to compare the efficacy of entecavir and tenofovir in nucleos(t)ide-naive chronic hepatitis B (CHB) patients with high viral load and/or high fibrosis scores at week 48 of therapy in terms of virological, serological, biochemical, and histological responses. Methods: We retrospectively rewieved our data of CHB patients. Nucleos(t)ide-naive CHB patients who had received ETV or TDF for at least 48 weeks with the following criteria were included in the present study: 1) liver biopsy prior to and at the end of week 48 of therapy, 2) pretreatment fibrosis scores ≥3 (Ishak) with any serum HBV DNA levels or serum HBV DNA levels ≥ 6 log copy/mL with any fibrosis scores. We compared the efficacy of ETV and TDF at week 4, week 12, week 24 and week 48 of therapy in terms of declines in serum HBV DNA levels, undetectable HBV DNA levels, and normalization of serum ALT levels. In addition, change in fibrosis scores and HBeAg seroconversion rates (in HBeAg positive patients) were evaluated at week 48 of therapy. Results: Totally, 44 Caucasian patients were included in the present study. Twenty-four patients had received ETV and 20 had received TDF. There were not statistically significant differences between patients who had received ETV and those who had received TDF in terms of age, gender, body mass index, HBeAg status, serum HBV DNA levels, ALT levels, histological activity index (HAI), and fibrosis scores at the beginning of therapy (Table 1). Declines in serum HBV DNA levels, achievement of undetectable serum HBV DNA levels, and normalization of serum ALT levels were similar in patients who had received ETV and TDF at week 4, week 12, week 24 and week 48 of therapy. At week 48 of therapy, serum HBV DNA levels decreased by 6,93±1,54 log copy/mL in ETV group and 6,89±1,22 log copy/mL in TDF group (p=0,654). Twenty-one of 24 (87,5%) patients in ETV group and 19 of 20 (95%) patients in TDF group achieved undetectable HBV DNA levels at week 48 (p=0,389). Serum ALT levels were normalized in 19 of 24 (79,17%) patients in ETV group and in 17 of 20 (85%) patients in TDF group (p=0,617). HBeAg seroconversion was achieved in 1 of 5 patients in ETV group and in 3 of 6 patients in TDF group (p=0,303). Mean
Su1003 Pregnant Women and Their Willingness to Be Treated for Hepatitis B During Pregnancy Andrew Ho, Tram T. Tran Background: Perinatal transmission in women with chronic hepatitis B virus (HBV) has been greatly reduced by immunoprophylaxis with hepatitis B immune globulin (HBIG) and HBV vaccination series, with reported 95% effectiveness. In women with high maternal viremia, perinatal transmission has been reported at higher rates, even with vaccination. Some studies have shown antiviral therapy during the third trimester of pregnancy reduces viral load in the mother and possibly decreases the risk of perinatal transmission. Perceptions regarding antiviral therapy for HBV in pregnancy is largely unknown. Methods: A translated questionnaire was given to pregnant women in waiting rooms at various obstetrics/gynecology clinics. Clinics with a large Asian population were targeted because of the high incidence of hepatitis B in that group. The questionnaire obtained information on demographic characteristics, obstetric history, family history of HBV, and personal history of HBV, perceptions of treatment and risks, including breastfeeding. Results: Seventy five patients were asked to participate in the study; 60 completed questionnaires and comprised the study population. Mean age was 32 years old (range 21-44). Fifty-five respondents (91%) were of Asian ethnicity. 93%
AASLD Abstracts
S-930