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In HBeAg+ patients (65/341) ALT flares were more common (P=0.03), especially for those who stopped TDF post-partum, requiring re-treatment in 21% (11/53). In comparison, 54% (116/215) of untreated women had a post-partum ALT flare; one with fulminant hepatitis underwent transplant 13months post-partum. HBsAg clearance occurred in 2.6% (9/341, 3/9 HBeAg+, 2/9 TDF treated) at median 30months (IQR 23-4 and 37% (24/65) of HBeAg+ patients had HBeAg loss at median 17months (IQR 12-26) post-partum. Post-partum ALT flares were common, especiall