Maternal chronic hepatitis B and entecavir therapy associate
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Case Report
A 29-year old pregnant woman, migrated from Africa with incidentally detected chronic hepatitis B about 4 years ago, delivered a preterm baby girl at 29 weeks of gestation, weighing 1534 gm following antepartum hemorrhage. Liver cirrhosis, portal hypertension, and splenomegaly were confirmed about 2 years before the pregnancy. She was commenced on entecavir (0.5 mg a day) 5 months prior to the conception, which was continued throughout the pregnancy. Additional comorbidities in this patient included thrombocytopenia and gestational diabetes mellitus (GDM) which was well controlled by diet only. Her clinical condition remained stable throughout the pregnancy.

Antenatal serology detected maternal hepatitis B surface antigen (HBsAg), anti-hepatitis B e-antibody, and anti-hepatitis B core antibody but tested negative for hepatitis B surface antibody and hepatitis B e-antigen (HBeAg). Hepatitis B viral load remained low measuring <15 IU/ml throughout pregnancy, assessed four times (using Roche AmpliPrep/COBAS Taqman HBV test version 2.0, with dynamic normal range of 20 IU/ml – 1.7 × 108 IU/ml), throughout and after the pregnancy. HIV 1 and 2, syphilis, cytomegalovirus, and hepatitis C were negative, and she was rubella immune. Maternal aminotransferase levels and coagulation profile were both normal. Antenatal fetal ultrasonography at 23 weeks showed multiple small echogenic areas across the liver and bowel which continued to progress on the subsequent scans. The neonate received hepatitis B immunoglobulin and hepatitis B vaccine soon after birth. HBsAg was negative in the neonate measured at birth and at 6 months of age.....;year=2017;volume=6;issue=2;spage=106;epage=108;aulast=Shee
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