[New possibilities for the newborn’s protection against vertical HBV trasmission – a case report]

The patient was diagnosed with chronic hepatitis B at 19 years old. Biochemical, serological and histopathological diagnostic processes were followed by pegylated interferon treatment. After 24 weeks of therapy treatment was discontinued due to pathological thyroid hormones values. The patient was diagnosed with Hashimoto’s thyroiditis and levothyroxine therapy initiated. Over the following two years, the patient was not under hepatology specialist care. She was admitted to the Clinic due to a high aminotransferase level and concomitant pruritus in the 32nd week of her first pregnancy. In the end the patient was diagnosed as having an exacerbation of chronic hepatitis B. After recognition of high HBV (hepatitis B virus) viremia, treatment with tenofovir was initiated. In the course of treatment the following were observed: HBeAg/anti-Hbe (antigen HBe/anti-HBe antibodies) seroconversion, decrease in viral load, biochemical normalization; and an improvement in clinical status of the patient was obtained. An elective caesarean section was performed in week 40; the new-born received 10 points on the Apgar scale. During the first hours of life, the passive-active immunoprophylaxis: immunoglobulin and the first dose of anti-HBV vaccine, were given to the new-born. Over long-term observation it was found that there was no vertical transmission of the hepatitis B virus to the child.