Pregnant woman with fulminant hepatic failure caused by hepatitis B virus infection: A case report

Yang, Yongtao; Li, Xiaomao; Shi, Zhijun; Ma, Lin

doi:10.3748/wjg.v10.i15.2305

Cited by 39 publications

(31 citation statements)

References 12 publications

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“…However, case reports of hepatic exacerbations/fulminant hepatic failures in HBsAg-positive pregnant women have been reported. 15,16 A proportion of women have hepatitis flares with or without HBeAg seroconversion (12.5-17%) within the first months after delivery. [17][18][19] Among HBeAg positive chronic HBV-infected mothers, low HBeAg titers and low HBV DNA viral loads have been associated with HBeAg loss after delivery.…”

Section: Effect Of Pregnancy On Chronic Hepatitis B Virus Infectionmentioning

confidence: 99%

Chronic Hepatitis B Virus Infection and Pregnancy

Kumar

Singh

Sinha

2012

Journal of Clinical and Experimental Hepatology

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Planning of pregnancy and management of chronic hepatitis B virus during pregnancy includes recognition of maternal virological status, assessment of liver disease severity and minimization of risk for mother to infant transmission of infection. Decisions regarding the use of antivirals during pregnancy need to be individualized. Monitoring for infection and immunization in newborns is also important. For mothers on antiviral therapy, breastfeeding is not recommended. ( J CLIN EXP HEPATOL 2012;2:366-381) A pproximately 400 million people are chronically infected with hepatitis B virus (HBV) worldwide, 1 and almost half have acquired their infections either through mother to infant transmission or in early childhood, especially in countries where HBV has intermediate to high prevalence.2 In Asia, 8%-10% of the population is chronically infected with HBV, and up to 50% of new cases of hepatitis B infection are due to mother to infant transmission.3 In contrast, the majority of new hepatitis B cases in developed countries are the result of horizontal transmission in adulthood. Before the adoption of standard passive-active immunoprophylaxis treatment, approximately 70%-90% of infants born to hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) positive mothers became chronically infected with HBV. 4 The mother to infant transmission rate was reduced to 5%-10% when infants received appropriate postnatal hepatitis B immunoglobulin (HBIg) and a series of HBV vaccines. However, despite passive-active immunoprophylaxis provided to infants, up to 8%-30% of infants born to highly viremic mothers still become infected with HBV (Figures 1-3). This review will address several issues important to chronic hepatitis B virus infection and pregnancy including effect of pregnancy on chronic HBV infection, effect of chronic HBV infection on pregnancy, mother to infant transmission, safety data on HBV antivirals during pregnancy, management of chronic HBV infection in women who desire pregnancy or become pregnant while taking antivirals. PREVALENCE OF CHRONIC HEPATITIS B VIRUS INFECTION AMONG PREGNANT WOMEN IN INDIAThe prevalence of chronic HBV infection varies widely, with rates ranging from 0.1% to 20% in different parts of the world.2 "High" prevalence (HBsAg positivity rates > 8%) regions include the Asia (except Japan), parts of the Middle East, sub-Saharan Africa, and the Amazon basin. "Intermediate" (2%-7% HBsAg positive) prevalence regions include, the Indian subcontinent, parts of central Asia and the Middle East, Eastern and Southern Europe, as well as parts of South America. "Low" prevalence (<2% HBsAg positive) regions include the United States, Northern Europe, Australia, Japan and the southern part of South America. Overall, 45% of the world population lives in "high" prevalence regions.The HBsAg positivity rate of Hepatitis B in India is different in the different regions of the country. The overall chronic HBsAg positivity rate is often quoted as being 4.7%.5 In India, the prevalence rate of HBsAg...

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Section: Effect Of Pregnancy On Chronic Hepatitis B Virus Infectionmentioning

confidence: 99%

Chronic Hepatitis B Virus Infection and Pregnancy

Kumar

Singh

Sinha

2012

Journal of Clinical and Experimental Hepatology

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“…Abnormalities of liver function are six times more common in a normal pregnancy than non-pregnancy [23,24]. Increase in serum bilirubin suggests either exacerbation of underlying pre-existing liver disease, liver disease related to pregnancy or liver disease unrelated to pregnancy.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Risk Factors Affecting the Outcome of Critically Ill Pregnant and Postpartum Women

Pan¹,

Sun²,

Gong³

et al. 2017

Chemotherapy

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The mortality of critically ill pregnant women is an important global health concern. Therefore, we evaluated the risk factors affecting the mortality of critically ill pregnant women admitted to the intensive care unit. All critically ill pregnant patients >18 year from the second affiliated hospital of Wenzhou Medical University. Finally, a total of 100 adult pregnant women were admitted to the intensive care unit. 69 pregnant women were survivor (28.29 ± 4.70 year) with gestational age of 33.33 ± 6.13 week; while 31 pregnant women non-survivor (29.50 ± 5.37 year) with gestational age of 33.21 ± 3.44 week. Multivariable logistic regression analysis showed that PT(OR:6.409; 95% CI, 1.855-22.140; p=0.003), total bilirubin (OR:3.125; 95% CI, 1.013-9.644; p=0.037) and APACHE III score (OR:4.750; 95% CI, 1.488-15.167; p=0.009) were associated with maternal mortality. Considering these promising results, PT, total bilirubin and APACHE III score significantly affect the outcomes of pregnant women admitted to the ICU. Critically ill pregnant patients with liver problems should be carefully monitored.

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“…HEV and HBV infections were most frequent cause of fulminant hepatic failure in pregnancy [3,4,5] . As far as developing countries like India is concerned, Hepatitis E is the most common cause of fulminant hepatic failure.…”

Section: A Study Of Liver Disorder and Its Consequences In Pregnant Wmentioning

confidence: 99%

A study of liver disorder and its consequences in pregnant women with jaundice in tertiary care centre in Belgaum, Karnataka, India

Karegoudar¹,

Dhirubhai²,

Dhital³

et al. 2014

IOSRJDMS

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Pregnant woman with fulminant hepatic failure caused by hepatitis B virus infection: A case report

Abstract: AIM:To report the experience in successfully treating pregnant women with severe hepatitis.

Cited by 39 publications

References 12 publications

Chronic Hepatitis B Virus Infection and Pregnancy

Chronic Hepatitis B Virus Infection and Pregnancy

Analysis of Risk Factors Affecting the Outcome of Critically Ill Pregnant and Postpartum Women

A study of liver disorder and its consequences in pregnant women with jaundice in tertiary care centre in Belgaum, Karnataka, India

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