Fulminant hepatitis B associated with a specific insertion in the basal core promoter region of hepatitis B virus DNA after immunosuppressive treatment.
We report a case of hepatitis B virus reactivation that occurred after immunosuppressive treatment in a hepatitis B surface antigen-negative patient with detectable antibodies to hepatitis B core antigen and hepatitis B surface antigen. Sequence analysis revealed an 11-bp insertion in the core promoter region of hepatitis virus DNA, creating a novel hepatocyte nuclear factor-1 binding site. This led to enhanced viral replication and fulminant hepatitis.
Gérolami
René
R
Service de Gastro-entérologie et Hépatologie, Hôpital de la Conception, Marseille, France.
Henry
Mireille
M
Borentain
Patrick
P
Colson
Philippe
P
Botta
Danièle
D
Tamalet
Catherine
C
D005260:Female; D006509:Hepatitis B / Q000188:drug therapy* / Q000821:virology; D006510:Hepatitis B Antibodies / Q000097:blood; D006512:Hepatitis B Core Antigens / Q000235:genetics* / Q000276:immunology; D006514:Hepatitis B Surface Antigens / Q000276:immunology; D006515:Hepatitis B virus / Q000235:genetics* / Q000276:immunology / Q000502:physiology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D017114:Liver Failure, Acute / Q000188:drug therapy* / Q000821:virology; D008969:Molecular Sequence Data; D009154:Mutation; D011401:Promoter Regions, Genetic / Q000235:genetics*; D014775:Virus Activation
D006510:Hepatitis B Antibodies; D006512:Hepatitis B Core Antigens; D006514:Hepatitis B Surface Antigens; D007166:Immunosuppressive Agents