Özet:

The acute flare of HBV infection in pregnancy has effects on two sides: the mother and the neonate. According to the recent reports, antiviral treatment has to be considered in mothers with high viral loads, particularly for reducing the risk of transmission-to baby. Here we report a case of pregnant patient treated with tenofovir for acute HBV infection. A 35 years old female patient, who was 32 weeks pregnant, had been hospitalized in another clinic with pre-diagnosis of hemolytic anemia, elevated liver enzymes, low platelet count (HELLP) syndrome, and then she was admitted to our hospital due to diagnosis of hepatitis B and decrease in her elevated liver enzyme levels. Her HBsAg status was unknown in her past pregnancies. Her laboratory results on admission were as follows: serum HBV-DNA level: 75 000 000 IU/mL, anti-HBc IgM: positive, anti-HBc IgG: positive, HBsAg: positive, anti-HBs: negative, HBeAg: positive and anti-HBe: negative. The patient was closely followed for the re-increasing liver enzymes and bilirubin levels. A probable acute liver failure was detected and supportive therapy was administered. Tenofovir treatment was also started in order to decrease HBV-DNA levels and to decrease the risk of perinatal transmission of the HBV to the upcoming fetus. On the 11th day of her admission she gave early birth to a 2010 grams baby-boy. The baby’s APGAR score was 8/9 and had respiratory distress syndrome. No pathology was detected in baby except a minimal left peripheral pulmonary stenosis on echocardiogram examination. Tenofovir treatment of the mother continued. 12 weeks later the patient’s liver enzymes were normal and her HBV-DNA was negative, HBeAg seroconversion was occurred. The baby was HBsAg negative, no side effects associated with tenofovir was detected. Acute HBV infection and hepatic failure in pregnancy requires a close follow-up. Antiviral treatment option should be considered especially in patients with high viral load, benefits and losses of the mother and the neonate should be considered for the treatment plan in each case.

Anahtar Kelimeler: