SUCCESSFUL EMPIRIC TREATMENT OF HSV HEPATITIS IN PREGNANCY - CASE-REPORT AND REVIEW OF THE LITERATURE

Herpes simplex hepatitis (HSH) occurring in pregnant women must be dif ferentiated from acute fatty liver of pregnancy (AFLP) and the HELLP s yndrome (hemolysis, elevated liver function tests, and low platelets), two diseases which are relatively more common hepatic disorders uniqu e to pregnancy (1). All three, however, are relatively unusual. In con trast to AFLP and the HELLP syndrome, a diagnosis of HSH must be made quickly, usually within 24 hr, as it is a rapidly progressive form of viral hepatitis which is associated with a very high mortality rate, p articularly in pregnant women (2). Twenty-seven cases of HSH occurring during pregnancy have been reported in the English literature availab le to the authors of this report (3-22). The introduction of acyclovir into clinical medicine has changed the outcome of HSH occurring in pr egnancy, such that survival is likely if the therapy is instituted ear ly (2, 13, 15-20). Herein, we report a case of HSH diagnosed clinicall y, that was subsequently confirmed serologically and was treated succe ssfully with acyclovir with survival of both the pregnant patient and her child.