Reactivation of hepatitis B virus infection with persistently negative HBsAg on three HBsAg assays in a lymphoma patient undergoing chemotherapy.
J Clin Virol
; 47(2): 193-5, 2010 Feb.
Article
en En
| MEDLINE
| ID: mdl-20031483
ABSTRACT
In patients with occult hepatitis B virus (HBV) infection, acute exacerbation may occur when they become immunocompromised. Usually, these patients develop hepatitis B surface antigen (HBsAg) seroreversion during the flare. Here we report on a patient with occult HBV infection, who developed HBV exacerbation after chemotherapy for diffuse large B-cell lymphoma. The resurgence of HBV DNA preceded the elevation of liver enzymes for 20 weeks. Atypically, despite high viraemia, serological tests showed persistently negative HBsAg using three different sensitive HBsAg assays (i.e., Architect, Murex and AxSYM). On comparing the amino acid sequence of the index patient with the consensus sequence, five mutations were found at pre-S1, five at pre-S2 and twenty-three mutations at the S region. Six amino acid mutations were located in the 'a' determinant, including P120T, K122R, M133T, F134L, D144A and G145A. The mutants K122R, F134L and G145A in our patient have not been tested for their sensitivity to Architect and Murex assays by the previous investigators and might represent the escape mutants to these assays.
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Activación Viral
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Virus de la Hepatitis B
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Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos
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Hepatitis B
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Antígenos de Superficie de la Hepatitis B
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Linfoma
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Antineoplásicos
Límite:
Aged
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Animals
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Humans
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Male
Idioma:
En
Revista:
J Clin Virol
Asunto de la revista:
VIROLOGIA
Año:
2010
Tipo del documento:
Article
País de afiliación:
Hong Kong