Spontaneous reactivation of hepatitis B virus replication in an HIV coinfected patient with isolated anti-Hepatitis B core antibodies.
Co-infections with HBV (hepatitis B virus) occur in HIV (human immunodeficiency virus) patients frequently. It has been reported that an effective treatment of HIV can also lead to a suppression of HBV and to anti-HBs seroconversion in HBV-infected patients. Here, we report a spontaneous reactivation of HBV replication in an HIV-infected patient with anti-HBc as the only marker of chronic HBV infection. The patient was known to be coinfected with HIV and HBV for years and the HBV DNA was measured repeatedly at low levels. A significant increase of HBV DNA up to 1.7 x 10⁷ IU/ml was found accompanied with clinical symptoms of hepatitis. Multiple mutations occurred in the S gene during the flare-up of HBV as shown by sequencing, including I103T, K122R, M133I, F134V, D144E, V164E and L175S. Anti-HIV/HBV treatment led to a resolution of symptoms and to a decrease in the HIV RNA and HBV DNA viral load. It is possible that the accumulated mutations during HBV replication were selected and responsible for the reactivation.
Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan 430071, China. rongjuan_pei@wh.iov.cn.
Rongjuan
R
Pei
Sebastian
S
Grund
Jens
J
Verheyen
Stefan
S
Esser
Xinwen
X
Chen
Mengji
M
Lu
D000998:Antiviral Agents / Q000627:therapeutic use; D060085:Coinfection / Q000276:immunology* / Q000821:virology*; D004279:DNA, Viral / Q000097:blood; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy / Q000276:immunology*; D006510:Hepatitis B Antibodies / Q000097:blood; D006512:Hepatitis B Core Antigens / Q000097:blood / Q000235:genetics; D006515:Hepatitis B virus / Q000502:physiology*; D019694:Hepatitis B, Chronic / Q000150:complications / Q000188:drug therapy / Q000276:immunology* / Q000821:virology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D050505:Mutant Proteins / Q000097:blood / Q000235:genetics; D020125:Mutation, Missense; D019562:Viral Load; D014775:Virus Activation
D000998:Antiviral Agents; D004279:DNA, Viral; D006510:Hepatitis B Antibodies; D006512:Hepatitis B Core Antigens; D050505:Mutant Proteins