title: Chronic HBV with pregnancy: reactivation flare causing fulminant hepatic failure.
abstract: Chronic HBV infection is a dynamic state of interaction between HBV, hepatocytes, and the immune system of the host. A series of reactivation flares and remissions may occur due to multiple causes. Among them, spontaneous reactivation and immunosuppressive drugs including steroids or cancer chemotherapy are well known. This is due to immune-mediated destruction of HBV-expressing cells following withdrawal of immunosuppressive effect. Few cases have been reported in females during postpartum period. We report a case of fulminant hepatic failure during pregnancy in a previously unrecognized hepatitis B positive female requiring emergent liver transplantation.
authors.affiliation: Nazih Zuhdi, Transplant Institute, INTEGRIS Baptist Medical Center, Oklahoma City, Oklahoma 73112, USA.
authors.forename: Ashish
authors.initials: A
authors.lastname: Singhal
authors.forename: Rajesh
authors.initials: R
authors.lastname: Kanagala
authors.forename: Sajid
authors.initials: S
authors.lastname: Jalil
authors.forename: Harlan I
authors.initials: HI
authors.lastname: Wright
authors.forename: Vivek
authors.initials: V
authors.lastname: Kohli
mesh_terms: D000208:Acute Disease; D000328:Adult; D005260:Female; D019694:Hepatitis B, Chronic / Q000150:complications* / Q000276:immunology / Q000601:surgery; D006801:Humans; D017114:Liver Failure, Acute / Q000276:immunology / Q000601:surgery / Q000821:virology*; D016031:Liver Transplantation; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000276:immunology / Q000601:surgery / Q000821:virology*