Hepatitis B virus subgenotype F3 reactivation with vaccine escape mutations:A case report and review of the literature

作     者：Stefan Schlabe Kathrin van Bremen Souhaib Aldabbagh Dieter Glebe Corinna M Bremer Tobias Marsen Walter Mellin Veronica Di Cristanziano Anna M Eis-Hübinger Ulrich Spengler 

作者机构：German Center of Infectious Diseases Research(DZIF)Partner-Site Cologne-BonnBonn-Cologne35392Germany Department of Internal Medicine IUniversity Hospital of BonnBonn 53127Germany Institute of VirologyUniversity Hospital of BonnBonn 53127Germany Institute of Medical VirologyJustus Liebig University GiessenNational Reference Center for Hepatitis B and D VirusesBiomedical Research Center SeltersbergGiessen 35392Germany German Center of Infectious Diseases Research(DZIF)Partner-Site GiessenGiessen 35392Germany Practice of Nephrology and DialysisNephrological Center Cologne-LindenthalCologne 50937Germany Practice of Pathology and CytologyCologne 50931Germany Institute of VirologyUniversity Hospital of CologneCologne 50935Germany 

出 版 物：《World Journal of Hepatology》 (世界肝病学杂志（英文版）（电子版）)

年 卷 期：2018年第10卷第7期

页      面：509-516页

学科分类：10[医学] 

基　　金：Janssen 

主　　题：Entecavir Hepatitis B virus Subgenotype F3 Kidney transplantation Vaccine escape mutant G145R 

摘      要：Hepatitis B represents a global health threat because its chronic course and sequelae contribute to a high morbidity and mortality. Hepatitis B virus(HBV) infection can be controlled by vaccines, antiviral treatment, and by interrupting transmission. Rare vaccine escape mutants are serious because they eliminate vaccine protection. Here, we present a 74-year-old vaccinated patient with HBV reactivation 11 years after kidney transplantation. The patient was HBV-positive but HBs Ag-negative prior to vaccination 6 years before transplantation. The reactivated virus was HBV genotype F3 with vaccine escape mutations G145 R, P120 Q, and Q129 P. The patient was successfully treated with entecavir. The epidemiological reasons for this subgenotype, which is extremely rare in Western Europe, were unclear. This case illustrates that second-generation vaccines are not always effective in a specific group of patients.