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A case of hepatitis B reactivation due to the hepatitis B virus escape mutant in a patient undergoing chemotherapy.

Abstract：

:A 62-year-old man had chronic hepatitis B virus (HBV) infection and was diagnosed with liver cirrhosis. At the time of diagnosis the patient's virologic markers were positive for hepatitis B surface antigen (HBsAg), antibody to hepatitis B e antigen (anti-HBe) and antibody to hepatitis B core antigen (anti-HBc), while antibody to hepatitis B surface antigen (anti-HBs) and HBV DNA were negative. Later the patient received chemotherapy for malignancy. However, this was interrupted due to elevated liver enzymes. At the same time HBV DNA became positive. Lamivudine (LMV) therapy was administered immediately. However, the levels of serum aminotransferase and total bilirubin (TB) were still rising. Finally the patient died of fulminant hepatic failure. A sequence revealed HBV genotype C (HBsAg subtype adw) with immune escape mutations, F8L, S34L, F41S, G44V, F93C, V96G, L110I, C149Y and F161Y. The high morbidity and mortality of this complication is one of the major obstacles to completing the standard treatment for malignancy in HBV carriers. Therefore, the relative risk of antiviral prophylactic failure should be further assessed and the optimal strategy for antiviral prophylaxis in HBsAg-positive patients with oncologic and hematologic malignancies undergoing chemotherapy should be revised.

journal_name

Virol Sin

journal_title

Virologica Sinica

authors

Wu C,Shi H,Wang Y,Lu M,Xu Y,Chen X

doi

10.1007/s12250-012-3284-3

subject

Has Abstract

pub_date

2012-12-01 00:00:00

pages

369-72

issue

6

eissn

1674-0769

issn

1995-820X

journal_volume

27

pub_type

杂志文章

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