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Open Access Case Report

Spontaneous reactivation of hepatitis B virus replication in an HIV coinfected patient with isolated anti-Hepatitis B core antibodies

Rongjuan Pei12*, Sebastian Grund3, Jens Verheyen2, Stefan Esser4, Xinwen Chen1 and Mengji Lu12

Author Affiliations

1 Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan 430071, China

2 Institute of Virology, University Hospital of Essen, University Duisburg-Essen, Essen, Germany

3 Institute for Virology, University of Düsseldorf, Düsseldorf, Germany

4 Clinic of Dermatology, University Hospital Essen, University Duisburg-Essen, Essen, Germany

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Virology Journal 2014, 11:9  doi:10.1186/1743-422X-11-9

Published: 21 January 2014

Abstract

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 1.7x107 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.

Keywords:
HBV; HIV; Anti-HBc only; Reactivation; Mutation