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Reactivation of precore variant hepatitis B virus in a child with severe aplastic anaemia
Author(s) -
Smith P.R.,
Zampino R.,
Gutteridge C.,
Karayiannis P.,
Aitken C.
Publication year - 2001
Publication title -
journal of medical virology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.782
H-Index - 121
eISSN - 1096-9071
pISSN - 0146-6615
DOI - 10.1002/jmv.2059
Subject(s) - virology , virus , hepatitis a virus , hepatitis b virus , hepatitis , medicine , biology
Reactivation of hepatitis B e antigen (HBeAg) negative chronic hepatitis B virus (HBV) infection due to selection of precore variant virus is an uncommon complication of previous hepatitis B infection, and virtually unrecognised in children and adolescents. A child who had received treatment with methylprednisolone and antilymphocyte globulin for severe aplastic anaemia developed high levels of detectable HBV DNA associated with hepatitis B e antibody (anti‐HBe) positivity. HBV DNA was extracted, amplified and the core and precore regions sequenced from 2 samples. A mixture of wild‐type and the precore variants A 1896 and A 1899 was detected in both samples, with the wild‐type predominating in the second sample. Reinfection was excluded by phylogenetic analysis using Phylip and the neighbour‐joining method. Precore variant Hepatitis B virus can be transmitted to children as a primary infection, and it is important that aggressive liver disease, particularly in the presence of the anti‐HBe phenotype, be investigated. Further studies are needed to determine the frequency of these variants. J. Med. Virol. 65:470–472, 2001. © 2001 Wiley‐Liss, Inc.