WHO recommends pregnant women with a high hepatitis B viral load receive tenofovir during pregnancy to prevent mother-to-child transmission, however there is limited access to viral load testing across Vanuatu and other Pacific Island Countries. This field trial compares the effectiveness of WHO-based guidelines to an alternative model of care, in which all hepatitis B-infected pregnant women receive tenofovir without requiring viral load testing, to prevent mother-to-child transmission of hepatitis B.
The project aims to:
2023–2025.
A two-arm, parallel group, randomised trial with hepatitis B-infected pregnant women attending antenatal clinics in Port Vila, Vanuatu. Infants will be tested 6-12 months after birth.
The treat-all approach is highly novel and will facilitate a major paradigm shift in prevention of mother-to-child transmission of hepatitis B in low and low-middle income countries including Pacific Island Countries.
Pacific regional stakeholders will be consulted to determine the best strategy for regional roll-out of updated guidance.
The impact of the intervention will be immediate in terms of averting hepatitis B infections in infants in Vanuatu. Scale-up of the intervention across the Pacific could avert hundreds of infections each year.