Reactivation of an occult hepatitis B virus escape mutant in an anti-HBs positive, anti-HBc negative lymphoma patient

Awerkiew, Sabine; Däumer, Martin; Reiser, Marcel; Wend, Ulrike C.; Pfister, Herbert; Kaiser, Rolf; Willems, Wulf R.; Gerlich, Wolfram H.

doi:10.1016/j.jcv.2006.10.006

Cited by 78 publications

(70 citation statements)

References 29 publications

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“…Though anti-HBc has been known as a pathognomonic marker of HBV infection, the titer of anti-HBc can decrease after a long period of time [17] , and anti-HBc negativities in a chronic HBV carrier were also reported in cases of decreased humoral immunity and mutants of HBcAg [18][19][20] . In an anti-HBc-negative and anti-HBspositive lymphoma patient, reactivation of the HBV virus was reported after immunosuppressive therapy, which indicates that anti-HBc-negative occult HBV infection exists [21] . Because anti-HBc has been considered as a pathognomonic marker of previous HBV infection, most of the studies of occult HBV infection were conducted on anti-HBc-positive subjects.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Occult Hepatitis B Virus Infection in a General Adult Population in Korea

et al. 2009

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Objectives: We investigated the prevalence of hepatitis B virus (HBV) markers and occult HBV infection in a general adult population in Korea. Methods: HBsAg, anti-HBs and anti-HBc were analyzed on 1,091 samples of routine medical check-up examinees by chemiluminescence immunoassay. Nucleic acid amplification test (NAT) was performed on 1,047 HBsAg-negative samples by multiplex real-time polymerase chain reaction (PCR) kit for simultaneous detection of HBV, hepatitis C virus, and human immunodeficiency virus (Cobas Taqscreen MPX) in pools of six and reactive pools were resolved to individual samples, and further discriminated by PCR-based assay for HBV (Cobas Ampliscreen HBV). Results: The prevalences of HBsAg, anti-HBc, and anti-HBs were 4.0, 39.3, and 75.4%, respectively. The prevalence of anti-HBc significantly decreased with decreasing age (p< 0.001). Occult HBV infection was found in 7 (0.7%) of 1,047 HBsAg-negative subjects, and 5 of them were anti-HBc-negative. Sequencing of HBV S gene in 3 cases revealed one wild-type and two mutant strains (W74S, F85Y; T63I, W74S, T131N substitutions). Conclusions: This study helps to understand the current status of hepatitis B infection and the prevalence of occult HBV infection in a general adult population in Korea.

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Section: Discussionmentioning

confidence: 99%

Prevalence of Occult Hepatitis B Virus Infection in a General Adult Population in Korea

et al. 2009

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“…Reactivation of occult HBV infection in unvaccinated patients with anti-HBs-positive status associated with past exposure to HBV may result in vaccine escape mutants (9). The inability of some commercial assays to detect the HBsAg associated with vaccine escape mutants despite high virus loads further complicates the picture (48).…”

Section: Host Immune Responses and Occult Hbv Infectionmentioning

confidence: 99%

Molecular Mechanisms Underlying Occult Hepatitis B Virus Infection

2012

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SUMMARY Chronic hepatitis B virus (HBV) infection is a complex clinical entity frequently associated with cirrhosis and hepatocellular carcinoma (HCC). The persistence of HBV genomes in the absence of detectable surface antigenemia is termed occult HBV infection. Mutations in the surface gene rendering HBsAg undetectable by commercial assays and inhibition of HBV by suppression of viral replication and viral proteins represent two fundamentally different mechanisms that lead to occult HBV infections. The molecular mechanisms underlying occult HBV infections, including recently identified mechanisms associated with the suppression of HBV replication and inhibition of HBV proteins, are reviewed in detail. The availability of highly sensitive molecular methods has led to increased detection of occult HBV infections in various clinical settings. The clinical relevance of occult HBV infection and the utility of appropriate diagnostic methods to detect occult HBV infection are discussed. The need for specific guidelines on the diagnosis and management of occult HBV infection is being increasingly recognized; the aspects of mechanistic studies that warrant further investigation are discussed in the final section.

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“…Few reports exist of HBV reactivation following rituximab treatment in patients positive for anti-HBs alone, but reactivation may occur, and these patients require careful observation [17,29,55] . Perhaps in these cases, antibody production may have declined with age, only anti-HBs remain and the specific details are unknown.…”

Section: Anti-hbc-positive Anti-hbs-negative and Hbsagnegative Casesmentioning

confidence: 99%

“…However, as mentioned above, just as anti-HBs decline and disappear when using rituximab, antibodies might not be produced after the pre-administration of a vaccine and the vaccine must be administered after completion of the treatment. On the other hand, cases may also exist in which hepatitis arising from HBV reactivation cannot be suppressed by a vaccine [55] . Perhaps HBV reactivation cannot be prevented solely by a vaccine.…”

Section: Nucleoside Analog Treatment For the Prevention Of Hbv Reactimentioning

confidence: 99%

Hepatitis B virus reactivation with rituximab-containing regimen

Tsutsumi¹,

Yamamoto²,

Shimono³

et al. 2013

WJH

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Rituximab is recognized as a useful drug for the treatment of B-cell non-Hodgkin's lymphoma and its use has been extended to such diseases as idiopathic thrombocytopenic purpura, thrombotic thrombocytopenic purpura, chronic rheumatoid arthritis and AN-CA-associated vasculitides. One serious complication associated with its use is the reactivation of hepatitis B virus and the search for methods to prevent this occurrence has resulted in the rapid accumulation of knowledge. In this review, we discuss case analyses from our department and other groups and outline the current knowledge on the topic and the remaining issues.© 2013 Baishideng Publishing Group Co., Limited. All rights reserved.Key words: Rituximab; Hepatitis B virus; Reactivation; Chemotherapy; Lamivudine; Non-Hodgkin's lymphoma Core tip: The deleterious effects of hepatitis B virus (HBV) reactivation in rituximab-containing chemotherapy regimens have been reported and the effect of lamivudine treatment in the prevention of HBV reactivation is also well documented. Once reactivated, HBV may lead to death due to hepatitis. In this review, we discuss the factors of preventive lamivudine treatment (especially in the course of HBV antibody), including to whom and for how long the drug should be given, based on case studies and reports that span rituximab's debut in 2002 on the Japanese market to June 2013.

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Reactivation of an occult hepatitis B virus escape mutant in an anti-HBs positive, anti-HBc negative lymphoma patient

Cited by 78 publications

References 29 publications

Prevalence of Occult Hepatitis B Virus Infection in a General Adult Population in Korea

Prevalence of Occult Hepatitis B Virus Infection in a General Adult Population in Korea

Molecular Mechanisms Underlying Occult Hepatitis B Virus Infection

Hepatitis B virus reactivation with rituximab-containing regimen

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