A 55-year-old male with no relevant medical history presented with a 5-day history of asthenia, hypoxia, cutaneous and conjunctival jaundice, colloric urine and stools
In the emergency analysis we highlight the presence of cytolysis (GOT 1720 IU/dl, GPT 2660 IU/dl), hyperbilirubinemia (total bilirubin 20.94 mg/dl), INR activity 45%, coagulopathy
In viral serology the presence of HBsAg positive with anti-HBc IgM positive and HBeAg positive stands out.
Serology of HCV, HDV and HIV were negative.
Because of the presence of severe acute liver failure, it was decided to establish specific treatment for acute HBV hepatitis with tenofovir 245 mg/24 hours from day 1 of hospital admission.
The patient was admitted to hospital for 14 days without hepatic encephalopathy or external signs of bleeding at any time, improving laboratory values from day +7 of antiviral treatment.
Subsequently, the patient continued treatment with tenofovir on an outpatient basis, with anti-HBe seroconversion occurring one month after treatment and HBsAg negative at 8 weeks of treatment.
After two consecutive HBsAg negative and antiHBs positive serology, antiviral treatment was suspended.
