Abstract

In chronic hepatitis B (CHB) carriers, alanine transaminase (ALT) flares are common in the peripartum period. There are limited data on immunological changes of pregnancy in CHB. We hypothesize that in pregnant CHB carriers, the Th1/Th2 cytokine ratio is altered resulting in changes in biochemical/virological and liver fibrosis markers. Serum from 38 pregnant/post-partum CHB carriers (median age 32years, 53% Asian, 8 HBeAg+ ) was tested for HBV DNA, quantitative HBV surface antigen, ALT and liver fibrosis by transient elastography (TE). Serum cytokines were analyzed using a Luminex assay. Untreated CHB cases had mild ALT flares post-partum, but showed normal TE, and no change in viral markers despite increased Th1 cytokines compared to healthy controls (P<.05). CHB carriers show increased Th1 cytokines in the peripartum period albeit with no effect on viral load or liver disease suggesting an aborted antiviral immune response.

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