Tenofovir in the Management of Chronic Hepatitis B Infection During Pregnancy

Abstract

Chronic hepatitis B infection has a worldwide distribution, with approximately 350 million infected persons. While become more of an issue during pregnancy concerning maternal and fetal well-being and the influence of pregnancy itself on the course of the disease; the natural history of chronic hepatitis B infection during pregnancy has not been clearly established. This paper reports the outcome of pregnancy in a patient with chronic hepatitis B infection who discontinued double antiviral treatment since she wanted to get pregnant but then was administered tenofovir disoproxil fumarate (TDF; 245 mg/day) monotherapy at the 32nd gestational week. Turkish Başlık: Gebelikte Kronik Hepatit B Enfeksiyonu Tedavisinde Tenofovir Anahtar Kelimeler: Tenofovir,Hepatit B, gebelik Kronik Hepatit B enfeksiyonu dünyada 350 milyon kişiyi etkilemiş yaygın bir enfeksiyondur. Gebelikte anne ve bebek sağlığı ve gebelik süreci için önemli bir sorun olan kronik Hepatit B enfeksiyonunun gebelikteki doğal seyri henüz açıkça tesbit edilememiştir. Bu yazı, Hepatit B enfeksiyonu için ikili antiviral tedavi almakta iken, gebelik planlamasıyla antiviral tedaviyi kesen bir hastanın, gebeliğin 32. haftasında tekrar tenofovir disoproxil fumarate (TDF; 245 mg/gün) tedavisine başlanması ile gebeliğin seyrini bildirmektedir.

Keywords

• Tenofovir, hepatitis B, pregnancy

Tenofovir in the Management of Chronic Hepatitis B Infection During Pregnancy

Öz

References

1. Oguzkurt L, Ozkan U, Ulusan S, Koc Z, Tercan F. Portal vein varia- tions: clinical implications and frequencies in routine abdominal multidetector CT. Diagn Interv Radiol 2007;13:75-80.
2. Yeşildağ A, Adanir E, Köroğlu M, Baykal B, Oyar O, Gülsoy UK. Incidence of left renal vein anomalies in routine abdominal CT scans. Tani Girisim Radyol 2004;10:140-3.
3. Vanneuville G, Viallet JF, Garcier JM La veine porte. In: Chevrel JP (ed). Anatomie clinique. Berlin: Springer-Verlag 1994;455-66.
4. Collardeau-Frachon S, Scoazec JY. Vascular development and differentiation during human liver organogenesis. Anat Rec 2008;291:614-27. [CrossRef]
5. Sadler TW. Langman’s Medical Embryology. 8th ed. Lippincott Williams & Wilkins; 2000.
6. Fan ST, Wong Y. Absent middle hepatic vein in a right liver graft donor. Hepatobiliary Pancreat Dis Int 2008;7:430-2.
7. Fan ST, Lo CM, Liu CL, Wang WX, Wong J. Safety and necessity of including the middle hepatic vein in the right lobe graft in adult-to- adult live donor liver transplantation. Ann Surg 2003;238:137-48. [CrossRef]
8. Sahani D, Mehta A, Blake M, Prasad S, Harris G, Saini S. Pre- operative hepatic vascular evaluation with CT and MR angiogra- phy: implications for surgery. Radiographics 2004;24:1367-1380. [CrossRef]

9. Trigaux JP, Vandroogenbroek S, De Wispelaere JF, Lacrosse M, Jamart J. Congenital anomalies of the inferior vena cava and left renal vein: evaluation with spiral CT. J Vasc Interv Radiol 1998;9:339-45. [CrossRef]
10. Chai JW, Lee W, Yin YH, Jae HJ, Chung JW, Kim HH, et al. CT angiography for living kidney donors: accuracy, cause of mis- interpretation and prevalence of variation. Korean J Radiol 2008;9:333-9. [CrossRef]
11. Karaman B, Koplay M, Ozturk E, Basekim CC, Ogul H, Mutlu H, et al. Retroaortic left renal vein: multidetector computed tomogra- phy angiography findings and its clinical importance. Acta Radiol 2007;48:355-60. [CrossRef]
12. Satyapal KS, Kalideen JM, Haffejee AA, Singh B, Robbs JV. Left renal vein variations. Surg Radiol Anat 1999;21:77-81. [CrossRef]
13. Mendizábal S, Román E, Serrano A, Berbel O, Simón J. Left renal vein hypertension syndrome. Nefrologia 2005;25:141-6.
14. Barrier P, Otal P, Garcia O, Vahdat O, Domenech B, Lannareix V, et al. Aorta-left renal vein fistula complicating an aortic an- eurysm: preoperative and postoperative multislice CT findings. Cardiovasc Intervent Radiol 2007;30:485-7. [CrossRef]
15. Arslan H, Etlik O, Ceylan K, Temizoz O, Harman M, Kavan M. Incidence of retro-aortic left renal vein and its relationship with varicocele. Eur Radiol 2005;15:1717-20. [CrossRef]
16. Karazincir S, Balci A, Görür S, Sumbas H, Kiper AN. Incidence of the retroaortic left renal vein in patients with varicocele. J Ultra- sound Med 2007;26:601-4.
17. Yagci B, Tavasli B, Karabulut N, Kiroglu Y. Clinical significance and renal haemodynamics of incidentally detected retroaortic left re- nal vein: assessment with venous Doppler sonography. Br J Ra- diol 2008;81:187-91. [CrossRef]
18. Brancatelli G, Galia M, Finazzo M, Sparacia G, Pardo S, Lagalla R. Retroaortic left renal vein joining the left common iliac vein. Eur Radiol 2000;10:1724-5. [CrossRef]
19. McAllister JD, Ross GJ, Samaha AM Jr. Retroaortic renal vein with tumor thrombus: MR findings. Urol Radiol 1992;13:170-2. [CrossRef]
20. Pinsk R, Nemcek AA Jr, Fitzgerald SW. Tumor thrombus in a ret- roaortic left renal vein and incidental right circumcaval ureter. Urol Radiol 1992;13:166-9. [CrossRef]
21. Washecka R, Hulnick DH, Catanese A, Farcon E. Postpartum renal vein thrombosis with left retroaortic renal vein. Urology 1987;29:548-51. [CrossRef]
22. Sakamoto N, Koizumi K, Asahina Y, Tazawa J, Maeda M, Marumo F, et al. Primary Budd-Chiari syndrome due to complex venous anomalies. Abdom Imaging 1997;22:499-501. [CrossRef] 207 2012; 29: 205-7 Turamanlar et al.
23. Middle Hepatic Vein and Left Renal Vein