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NCT Number: NCT05403047

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

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).

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Key information

Age range

16 year and older

Sex eligibility

Female

Study type

Interventional

Phase

Phase 4

Primary location

Hôpital Privé de Tokombéré

Tokonbéré, Cameroon

Location status: Recruiting

Location contact

Maaga DOURWE, MD

CONTACT

About this study

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.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

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.

Treatment and study plan

Fumarate, Tenofovir Disoproxil

Drug

all participants receive the intervention

Other names: TDF

Primary outcomes

  1. Proportion of children with HBsAg positive at 9-12 months of life (W36 - W48) in the study population,

    Time frame: measured between 36 and 48 weeks of life of the child of the mothers included in the study

    Proportion of HBsAg-positive children between 9 and 12 months of age in the study population, assessed by an automated test (mini VIDAS)

Secondary outcomes

  1. Proportion of eligible women who accepted the intervention among eligible women offered the intervention (acceptance rate)

    Time frame: measured from 7 months of pregnancy to 8 weeks postpartum

    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

  2. Compliance with treatment

    Time frame: from 28 weeks of pregnancy to 8 weeks postpartum

    Compliance with treatment, estimated by self-report questionnaire and pill count

  3. Progression of viral load

    Time frame: measured from 24 weeks of pregnancy until the end of treatment

    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)

  4. Estimate the protection rate of children with anti-HBs antibody level > 10 mIU/mL

    Time frame: measured between 36 and 48 weeks of life of the child of the mothers included in the study

    Proportion of children with anti-HBs Ac > 10 mIU/ml at 9-12 months / total number of children in the study.

  5. Assess the clinical and biological tolerance of TDF administration in mothers and children

    Time frame: measured from 28 weeks of pregnancy until the end of treatment

    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

  6. Assess the rate of women requiring extended treatment after delivery

    Time frame: Assess at 12 and 24 weeks postpartum

    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

  7. To assess the cost-effectiveness of the intervention (compared to vaccination alone, without hepatitis B immune globulin (Ig-anti HBV))

    Time frame: To evaluate throughout the study

    Incremental cost-effectiveness ratio of the intervention compared to the situation where children receive vaccination only (HBV vaccination at birth + pentavalent)

Study contacts

Contact information is provided by the study sponsor or research team.

Maaga DOURWE, MD

CONTACT

[email protected]

0697073424

Sponsors and collaborators

Lead sponsor

ANRS, Emerging Infectious Diseases

Other Gov

Registry information

Official study title

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

Acronym: TOPCHIB

Important dates

Study start
2023
Primary completion
2027
Study completion
2028
First posted
Jun 3, 2022
Registry last updated
Jun 29, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.