Fatal fulminant primary hepatitis B virus infections with G1896A precore viral mutants in southeastern France.
Fulminant hepatitis has been shown to occur in about 1% of acute hepatitis B virus (HBV) infections, and its mortality rate is nearly 70%. Specific HBV genotypic features have been pointed out in fulminant acute hepatitis B worldwide, but these associations remain controversial. We describe all four primary HBV infections diagnosed in 2008 in our institution in Marseille, southeastern France, including two fatal cases. HBV genotypes were D or E. Precore G1896A HBV mutants were detected in both fatal fulminant primary HBV infections. Hepatitis B surface antigen and hepatitis B e antigen (HBeAg) were negative in two and three cases, respectively, despite HBV DNA detection. Primary HBV infection remains a cause of death in France. The impact of the precore G1896A mutation on the severity of AHB deserves to be assessed in larger studies in this country.
Laboratoire de virologie, pôle des maladies infectieuses et tropicales clinique et biologique, fédération de bactériologie-hygiène-virologie, CHU Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France.
Laure
L
Panassié
Patrick
P
Borentain
Cyril
C
Nafati
Gilles
G
Bernardin
Barbara
B
Doudier
Vincent
V
Thibault
René
R
Gerolami
Philippe
P
Colson
D000328:Adult; D017809:Fatal Outcome; D005260:Female; D005602:France; D005838:Genotype; D006509:Hepatitis B / Q000235:genetics* / Q000276:immunology / Q000821:virology; D006512:Hepatitis B Core Antigens / Q000235:genetics*; D006513:Hepatitis B e Antigens / Q000235:genetics*; D006515:Hepatitis B virus / Q000235:genetics* / Q000472:pathogenicity; D006801:Humans; D017114:Liver Failure, Acute / Q000821:virology*; D008297:Male; D008875:Middle Aged; D009154:Mutation; D014758:Viral Core Proteins / Q000235:genetics*; D014779:Virus Replication
D006512:Hepatitis B Core Antigens; D006513:Hepatitis B e Antigens; D014758:Viral Core Proteins