title: Acute hepatitis B of genotype H resulting in persistent infection.
abstract: A 47-year-old man presented with general fatigue and dark urine. The laboratory data showed increased levels of hepatic transaminases. The patient was positive for hepatitis B virus (HBV) markers and negative for anti-human immunodeficiency virus. The HBV-DNA titer was set to 7.7 log copies/mL. The patient was diagnosed with acute hepatitis B. The HBV infection route was obscure. The serum levels of hepatic transaminases decreased to normal ranges without any treatment, but the HBV-DNA status was maintained for at least 26 mo, indicating the presence of persistent infection. We isolated HBV from the acute-phase serum and determined the genome sequence. A phylogenetic analysis revealed that the isolated HBV was genotype H. In this patient, the elevated peak level of HBV-DNA and the risk alleles at human genome single nucleotide polymorphisms s3077 and rs9277535 in the human leukocyte antigen-DP locus were considered to be risk factors for chronic infection. This case suggests that there is a risk of persistent infection by HBV genotype H following acute hepatitis; further cases of HBV genotype H infection must be identified and characterized. Thus, the complete determination of the HBV genotype may be essential during routine clinical care of acute hepatitis B outpatients.
authors.affiliation: Norie Yamada, Ryuichi Sugiyama, Takaji Wakita, Takanobu Kato, Department of Virology II, National Institute of Infectious Diseases, Shinjyuku-Ku, Tokyo 162-8640, Japan.
authors.forename: Norie
authors.initials: N
authors.lastname: Yamada
authors.affiliation: Norie Yamada, Ryuichi Sugiyama, Takaji Wakita, Takanobu Kato, Department of Virology II, National Institute of Infectious Diseases, Shinjyuku-Ku, Tokyo 162-8640, Japan.
authors.forename: Ryuta
authors.initials: R
authors.lastname: Shigefuku
authors.affiliation: Norie Yamada, Ryuichi Sugiyama, Takaji Wakita, Takanobu Kato, Department of Virology II, National Institute of Infectious Diseases, Shinjyuku-Ku, Tokyo 162-8640, Japan.
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Sugiyama
authors.affiliation: Norie Yamada, Ryuichi Sugiyama, Takaji Wakita, Takanobu Kato, Department of Virology II, National Institute of Infectious Diseases, Shinjyuku-Ku, Tokyo 162-8640, Japan.
authors.forename: Minoru
authors.initials: M
authors.lastname: Kobayashi
authors.affiliation: Norie Yamada, Ryuichi Sugiyama, Takaji Wakita, Takanobu Kato, Department of Virology II, National Institute of Infectious Diseases, Shinjyuku-Ku, Tokyo 162-8640, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Ikeda
authors.affiliation: Norie Yamada, Ryuichi Sugiyama, Takaji Wakita, Takanobu Kato, Department of Virology II, National Institute of Infectious Diseases, Shinjyuku-Ku, Tokyo 162-8640, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Takahashi
authors.affiliation: Norie Yamada, Ryuichi Sugiyama, Takaji Wakita, Takanobu Kato, Department of Virology II, National Institute of Infectious Diseases, Shinjyuku-Ku, Tokyo 162-8640, Japan.
authors.forename: Chiaki
authors.initials: C
authors.lastname: Okuse
authors.affiliation: Norie Yamada, Ryuichi Sugiyama, Takaji Wakita, Takanobu Kato, Department of Virology II, National Institute of Infectious Diseases, Shinjyuku-Ku, Tokyo 162-8640, Japan.
authors.forename: Michihiro
authors.initials: M
authors.lastname: Suzuki
authors.affiliation: Norie Yamada, Ryuichi Sugiyama, Takaji Wakita, Takanobu Kato, Department of Virology II, National Institute of Infectious Diseases, Shinjyuku-Ku, Tokyo 162-8640, Japan.
authors.forename: Fumio
authors.initials: F
authors.lastname: Itoh
authors.affiliation: Norie Yamada, Ryuichi Sugiyama, Takaji Wakita, Takanobu Kato, Department of Virology II, National Institute of Infectious Diseases, Shinjyuku-Ku, Tokyo 162-8640, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yotsuyanagi
authors.affiliation: Norie Yamada, Ryuichi Sugiyama, Takaji Wakita, Takanobu Kato, Department of Virology II, National Institute of Infectious Diseases, Shinjyuku-Ku, Tokyo 162-8640, Japan.
authors.forename: Kiyomi
authors.initials: K
authors.lastname: Yasuda
authors.affiliation: Norie Yamada, Ryuichi Sugiyama, Takaji Wakita, Takanobu Kato, Department of Virology II, National Institute of Infectious Diseases, Shinjyuku-Ku, Tokyo 162-8640, Japan.
authors.forename: Kyoji
authors.initials: K
authors.lastname: Moriya
authors.affiliation: Norie Yamada, Ryuichi Sugiyama, Takaji Wakita, Takanobu Kato, Department of Virology II, National Institute of Infectious Diseases, Shinjyuku-Ku, Tokyo 162-8640, Japan.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Koike
authors.affiliation: Norie Yamada, Ryuichi Sugiyama, Takaji Wakita, Takanobu Kato, Department of Virology II, National Institute of Infectious Diseases, Shinjyuku-Ku, Tokyo 162-8640, Japan.
authors.forename: Takaji
authors.initials: T
authors.lastname: Wakita
authors.affiliation: Norie Yamada, Ryuichi Sugiyama, Takaji Wakita, Takanobu Kato, Department of Virology II, National Institute of Infectious Diseases, Shinjyuku-Ku, Tokyo 162-8640, Japan.
authors.forename: Takanobu
authors.initials: T
authors.lastname: Kato
mesh_terms: D005838:Genotype; D006515:Hepatitis B virus / Q000235:genetics*; D019694:Hepatitis B, Chronic / Q000821:virology*; D006801:Humans; D008297:Male; D008875:Middle Aged
keywords: Acute hepatitis; Chronic hepatitis; Genotyping; Hepatitis B virus; Single nucleotide polymorphisms