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.
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.
Inoue
Jun
J
Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan.
Ueno
Yoshiyuki
Y
Kogure
Takayuki
T
Nagasaki
Futoshi
F
Kimura
Osamu
O
Obara
Noriyuki
N
Kido
Osamu
O
Nakagome
Yu
Y
Kakazu
Eiji
E
Matsuda
Yasunori
Y
Fukushima
Koji
K
Segawa
Haruna
H
Nakajima
Ichiro
I
Itoyama
Yasuto
Y
Takahashi
Masaharu
M
Okamoto
Hiroaki
H
Shimosegawa
Tooru
T
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
D004279:DNA, Viral; D006512:Hepatitis B Core Antigens; D006514:Hepatitis B Surface Antigens