The optimal management of acute
hepatitis B in pregnant women remains to be fully evaluated. A case of hepatitis B virus (HBV)
infection in a 20-year-old pregnant woman who initially presented with
jaundice is reported. Serum samples were positive for anti-HBc
IgM and HBe
antigen. Her husband was infected with HBV genotype A and received
entecavir because of prolonged
hepatitis and a high viral load. The HBV DNA sequence of the wife completely matched that of her husband, indicating that he was the source of HBV
infection. In accordance with guidelines for the treatment of chronic HBV carriers, the wife started to receive
tenofovir disoproxil fumarate (TDF) in her third trimester. After 4 months of treatment, the HBV
DNA load decreased from 7.6 to 3.5 log copies/ml. At delivery, the serum was found negative for the HBe
antigen. Seven months
after treatment began, the HBs
antigens also disappeared. The baby, totally healthy, received passive-active immunoprophylaxis. At 3 months, the baby remained free of HBV
infection. TDF thus prevented exacerbation and prolongation of acute HBV
infection in a pregnant woman. Subsequent treatment also prevented mother-to-infant transmission of HBV. The
clinical course of her husband, who had HBV
infection and received
entecavir, is also reported.