title: Breastfeeding while taking lamivudine or tenofovir disoproxil fumarate: a review of the evidence.
abstract: Lamivudine and tenofovir disoproxil fumarate (TDF) are both active against hepatitis B virus (HBV). Due to its potency, high genetic barrier to resistance, and safety during pregnancy, TDF may be useful to prevent HBV transmission from mother to child, which is the leading cause of transmission globally. Despite the safety record of lamivudine and TDF in pregnancy, the labels for both of these drugs recommend against their use during breastfeeding. In this review, we discuss the data regarding lamivudine and TDF use during pregnancy and breastfeeding and find that the exposure to the drug is lower from breastfeeding than from in utero exposure. Thus, the data do not support the contraindication to their use during breastfeeding.
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors.forename: Stephan
authors.initials: S
authors.lastname: Ehrhardt
authors.affiliation: Department of Infectious Diseases, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, China.
authors.forename: Chan
authors.initials: C
authors.lastname: Xie
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors.forename: Nan
authors.initials: N
authors.lastname: Guo
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland Division of Infectious Diseases, Department of Medicine, Johns Hopkins University Department of International Health.
authors.forename: Kenrad
authors.initials: K
authors.lastname: Nelson
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Johns Hopkins University Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors.forename: Chloe L
authors.initials: CL
authors.lastname: Thio
mesh_terms: D000225:Adenine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D001942:Breast Feeding; D018562:Disease Transmission, Infectious / Q000517:prevention & control*; D005260:Female; D006509:Hepatitis B / Q000188:drug therapy* / Q000517:prevention & control* / Q000635:transmission; D006801:Humans; D007231:Infant, Newborn; D019259:Lamivudine / Q000627:therapeutic use*; D063065:Organophosphonates / Q000627:therapeutic use*; D011247:Pregnancy; D000068698:Tenofovir
chemical_list: D019380:Anti-HIV Agents; D063065:Organophosphonates; D019259:Lamivudine; D000068698:Tenofovir; D000225:Adenine
keywords: breastfeeding; hepatitis B; lamivudine; tenofovir