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Results Three out of four HBV patients with occult infection, showed reactivation phases of HBV viremia. Different mutations were observed, with differences between preand post-reactivation sera. HBV-DNA remained at low levels during the entire study period also in absence of specific anti-HBV therapy. The phylogenetic analysis showed that, for each patient with HBV reactivation, all the isolates were originated from a unique parental virus. Specific mutations of PreS/S, Core and X regions were observed. Discussion Mutations in the “a” determinant of the S protein could be responsible for the absence of HBsAg detection. The presence of stop codon in the pre-core region and of mutations in the X region could, in part, explain the reactivation of HBV viremia.

Viral variability study in follow-up sera from HIV-HBV-HCV coninfected patients