Hepatitis B caused by a hepatitis B surface antigen escape mutant.
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.
Kajiwara
Eiji
E
Department of Gastroenterology, Internal Medicine and Pathology, Nippon Steel Yawata Memorial Hospital, 1-1-1 Harunomachi, Kitakyushu, 805-8508, Japan.
Tanaka
Yasuhito
Y
Ohashi
Tomoko
T
Uchimura
Kotarou
K
Sadoshima
Seizo
S
Kinjo
Mitsuru
M
Mizokami
Masashi
M
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
D000998:Antiviral Agents; D004279:DNA, Viral; D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens; D006513:Hepatitis B e Antigens; D019259:Lamivudine