title: [A case of repeated seroconversion to HBe antibody due to co-infection with Mutant- and wild-type hepatitis B virus clones].
abstract: It is reported that co-infection with different hepatitis B virus (HBV) clones in a patient with chronic hepatitis B induces rare serotypes (adywr) or abnormal laboratory data such as negative HBs antigen, in the presence of positive HBV DNA. In this study, we experienced a case of repeated seroconversion to HBe antibody in a patient with chronic hepatitis B. Since seroconversion is considered to be related to genetic mutations, we investigated the HBV genes in this male patient in his 30's. We amplified and cloned parts of the HBV genes by the polymerase chain reaction (PCR), and sequenced the PCR products. As a result, mutated HBV genes were found in the serum of each specified period. By DNA sequencing we confirmed the coexistence of different HBV clones (wild-type clone and pre-S deletion mutant) and that both clones had the same genotype C. These clones took turns to be dominant; when the wild-type clone was dominant, HBe antigen was positive, and when the mutant clone was dominant, HBe antibody was positive. These findings demonstrated that repeated seroconversion of HBe antigen to HBe antibody was induced by co infection with mutant- and wild-type HBV clones. It is interesting that increased aspartate aminotransferase (AST) and alanine aminotransferase (ALT) was noted at the time of the change from positive wild-type HBV clone to positive mutant clone.
authors.affiliation: Department of Clinical Laboratory, Showa University Hospital, Shinagawa-ku, Tokyo 142-8666.
authors.forename: Nobuyasu
authors.initials: N
authors.lastname: Yukimasa
authors.forename: Rumiko
authors.initials: R
authors.lastname: Matsuda
authors.forename: Keiichiro
authors.initials: K
authors.lastname: Yoneyama
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Takagi
authors.forename: Kunihide
authors.initials: K
authors.lastname: Gomi
mesh_terms: D000328:Adult; D002999:Clone Cells; D005814:Genes, Viral; D006510:Hepatitis B Antibodies / Q000032:analysis*; D006513:Hepatitis B e Antigens / Q000032:analysis / Q000276:immunology*; D006515:Hepatitis B virus / Q000235:genetics; D019694:Hepatitis B, Chronic / Q000276:immunology* / Q000821:virology; D006801:Humans; D008297:Male; D009154:Mutation
chemical_list: D006510:Hepatitis B Antibodies; D006513:Hepatitis B e Antigens