Hepatitis B caused by a hepatitis B surface antigen escape mutant

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J Gastroenterol. 2008;43(3):243-7. Epub 2008 Mar 29.

Hepatitis B caused by a hepatitis B surface antigen escape mutant.

Kajiwara E, Tanaka Y, Ohashi T, Uchimura K, Sadoshima S, Kinjo M, Mizokami M.

Department of Gastroenterology, Internal Medicine and Pathology, Nippon Steel

Yawata Memorial Hospital, 1-1-1 Harunomachi, Yahatahigashi-ku, Kitakyushu,

805-8508, Japan.

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.

PMID: 18373168 [PubMed - in process]

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