Abstract: Objective To explore the influence of HBV remobilization during the period of pregnancy. Methods The patients who delivered in the department of gynaecology and obstetrics, Beijing Ditan Hospital from January 1, 2012 to June 30, 2012 were selected. All of them were tested to be HBsAg carriers
more than two times within two years before pregnancy according to “chronic hepatitis B prevention and control guideline” of China in 2012. During pregnancy, HBV remobilized which characterized by HBV DNA ≥ 4 log10 copies/ml. The ALT level was abnormal from the first pregnancy period to postpartum 42 days. The conditions of pregnate patients with liver disease, the treatment and the pregnancy outcomes were retrospectively analyzed respectively. Results Research objects conformed to the divided and excluded conditions. The average value of the highest HBV DNA level was (6.2 ± 0.9) log10 copies/ml. One of the patients’ HBeAg turned to be positive after HBV remobilization, and the other twenty two patients’ HBeAgremained negative. The maximum value of ALT averaged (260.9 ± 203.6) U/L，and AST averaged (170.4 ± 129.1) U/L . 95.7% of the patients’ HBV DNA rebounded in the first trimester of pregnancy. With the
rebounding of HBV DNA, 68.6% of the patients appeared ALT disordered in the first trimester of pregnancy. However, the ALT peak value occured at any time during pregnancy, mainly at the secondary to tertiary period of pregnancy and postpartum. The ALT levels of 9 patients (9/23, 39.1%), 5 of whom were hospitalized for treatment and 1 was in postpartum care, were higher than twice of the upper limit of normal, ULN. Nine patients were given antiviral therapy during pregnancy (16 to 28 weeks, median 28 weeks), and achieved the curative effect of virological response and the liver functions returned to be normal completely. Ten (43.5%) of the twenty three patients had complication with diabetes, three (13.0%) had postpartum hemorrhage and one (4.3%) had preeclampsia. Fifteen patients (65.2%) were treated with caesarean and eight delivered normally and spontaneously, the average pregnancy were (39.2 ± 0.9) weeks, all live births without premature and low-birth-weight infant (LBWI). With twenty-eight weeks postpartum follow-up, seven patients (30.4%)spontaneously improved (HBV DNA ＜ 500 copies/ml，ALT normal); eight of the nine patients who had antiviral treatment continued medical treatment in postpartum and one patient withdrawed the drug; five patients were given antiviral treatment because of the abnormal postpartum ALT and two patients were given supportive liver protection therapy and the ALT backed to normal. Conclusions The HBV is likely to be active again in inactive HBsAg carriers during pregnancy. Inactive HBsAg carriers of pregnant patients on pregnancy should be monitored with HBV DNA and liver function. In order to prevent the aggravation of liver disease during pregnancy, timely treatment shall be given to the patients with HBV activity again, antiviral drugs can be used during pregnancy when necessary.