title: Hepatitis B caused by a hepatitis B surface antigen escape mutant.
abstract: Amino acid substitutions within the S gene involving the major antigenic a determinant of the hepatitis B virus (HBV) surface antigen (HBsAg) have been detected in cases of failure of immunization against the virus. Our report showed development of clinical hepatitis in presence of antibody to HBsAg in a healthy individual. A single amino acid substitution (G145R) within the a determinant of the HBsAg was determined by sequencing of the isolated HBV strain. Lamivudine treatment efficiently cleared the peripheral HBV DNA, HBsAg, and hepatitis B e antigen. In conclusion, the immune escape mutant in the S gene can cause hepatitis despite pre-existing naturally acquired immunity.
authors: Department of Gastroenterology, Internal Medicine and Pathology, Nippon Steel Yawata Memorial Hospital, 1-1-1 Harunomachi, Kitakyushu, 805-8508, Japan.
authors: Eiji
authors: E
authors: Kajiwara
authors: Yasuhito
authors: Y
authors: Tanaka
authors: Tomoko
authors: T
authors: Ohashi
authors: Kotarou
authors: K
authors: Uchimura
authors: Seizo
authors: S
authors: Sadoshima
authors: Mitsuru
authors: M
authors: Kinjo
authors: Masashi
authors: M
authors: Mizokami
mesh_terms: D000368:Aged; D019943:Amino Acid Substitution / Q000276:immunology; D000998:Antiviral Agents / Q000627:therapeutic use; D004279:DNA, Viral / Q000378:metabolism; D006509:Hepatitis B / Q000235:genetics / Q000276:immunology*; D006510:Hepatitis B Antibodies / Q000276:immunology*; D006514:Hepatitis B Surface Antigens / Q000235:genetics / Q000276:immunology*; D006513:Hepatitis B e Antigens / Q000276:immunology; D006515:Hepatitis B virus / Q000187:drug effects / Q000235:genetics*; D006801:Humans; D007113:Immunity, Innate / Q000235:genetics; D019259:Lamivudine / Q000627:therapeutic use; D008297:Male; D009154:Mutation; D020539:Sequence Analysis, Protein
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral; D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens; D006513:Hepatitis B e Antigens; D019259:Lamivudine