title: Analysis of the full-length genome of hepatitis B virus in the serum and cerebrospinal fluid of a patient with acute hepatitis B and transverse myelitis.
abstract: Although many extrahepatic manifestations have been described in patients with acute or chronic hepatitis B, there are few reports about neurological disorders. We describe a 55-year-old man who contracted acute hepatitis B virus (HBV) infection and transverse myelitis. His neurological findings were gradually reduced along with the recovery from hepatitis. The cerebrospinal fluid (CSF) was revealed to be positive for HBsAg and HBV DNA. Full-length sequences of HBV in his serum and CSF were determined, and it was revealed that these two isolates had mutations at nucleotide (nt) 1762/1764 in the core promoter region and nt 1896 in the precore region. They were identical to each other except for two ambiguous codes at nt 2020 and 2631 in the CSF isolate. After cloning of the amplicons, substitutions at nt 2020 and 2631 were found in 6 (38%) of the 16 CSF clones. One clone of the 6 CSF clones had an additional substitution at nt 2119. These substitutions were not found in 16 serum clones. The presence of HBV clones unique to CSF suggests that HBV was a possible causative agent of the myelitis.
authors.affiliation: Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Inoue
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Ueno
authors.forename: Takayuki
authors.initials: T
authors.lastname: Kogure
authors.forename: Futoshi
authors.initials: F
authors.lastname: Nagasaki
authors.forename: Osamu
authors.initials: O
authors.lastname: Kimura
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Obara
authors.forename: Osamu
authors.initials: O
authors.lastname: Kido
authors.forename: Yu
authors.initials: Y
authors.lastname: Nakagome
authors.forename: Eiji
authors.initials: E
authors.lastname: Kakazu
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Matsuda
authors.forename: Koji
authors.initials: K
authors.lastname: Fukushima
authors.forename: Haruna
authors.initials: H
authors.lastname: Segawa
authors.forename: Ichiro
authors.initials: I
authors.lastname: Nakajima
authors.forename: Yasuto
authors.initials: Y
authors.lastname: Itoyama
authors.forename: Masaharu
authors.initials: M
authors.lastname: Takahashi
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Okamoto
authors.forename: Tooru
authors.initials: T
authors.lastname: Shimosegawa
mesh_terms: D001483:Base Sequence; D002555:Cerebrospinal Fluid / Q000821:virology*; D004279:DNA, Viral / Q000097:blood / Q000134:cerebrospinal fluid / Q000737:chemistry / Q000235:genetics*; D016679:Genome, Viral; D006509:Hepatitis B / Q000150:complications / Q000821:virology*; D006512:Hepatitis B Core Antigens / Q000235:genetics; D006514:Hepatitis B Surface Antigens / Q000097:blood / Q000134:cerebrospinal fluid; D006515:Hepatitis B virus / Q000235:genetics* / Q000302:isolation & purification; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D009188:Myelitis, Transverse / Q000150:complications / Q000821:virology*; D017354:Point Mutation; D011401:Promoter Regions, Genetic; D011859:Radiography; D017422:Sequence Analysis, DNA; D044967:Serum / Q000821:virology*; D013116:Spinal Cord / Q000000981:diagnostic imaging
chemical_list: D004279:DNA, Viral; D006512:Hepatitis B Core Antigens; D006514:Hepatitis B Surface Antigens