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Successful interferon treatment in a patient chronically infected with hepatitis B virus carrying unusual S‐ (and P‐) mutants in the presence of anti‐HBs antibodies
Author(s) -
Frider Bernardo,
Alessio Analía,
Pozzati Marcia,
Cuestas María L.,
Mathet Verónica L.,
Oubiña José R.
Publication year - 2007
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/j.1478-3231.2007.01480.x
Subject(s) - hbsag , hbeag , hepatitis b virus , virology , seroconversion , medicine , antibody , immune system , pegylated interferon , immunology , interferon , hepatitis b , virus , epitope , hepatitis c virus , ribavirin
Background: Hepatitis B virus (HBV) immune escape mutants with point mutations within the S gene may arise during the natural course of HBV infection, due to a positive selection pressure exerted by the host immune response. Mutations within the immunodominant B and T cell epitopes of hepatitis B surface antigen (HBsAg) allow the resulting S‐mutants to propagate even in the presence of neutralizing anti‐HBs antibodies and the HBV‐specific T‐cell immune response. Aim: To study the antiviral effect of Pegylated‐interferon (Peg‐IFN) in a patient with chronic hepatitis B carrying unusual S‐(and P‐) mutants in the presence of anti‐HBs antibodies. Patients, Methods and Results: We report on a 43‐year‐old male chronically infected with a genotype A HBV strain, with cocirculation of both HBsAg and anti‐HBs antibodies, who received treatment with 120 μg of Peg‐IFN for 24 weeks. HBeAg seroconversion and clearance of both HBV DNA by polymerase chain reaction and HBsAg were successfully achieved. Improved histology was observed in a biopsy performed 44 weeks after Peg‐IFN therapy was completed. It seems plausible that the ascribed genotype A could have contributed to the effective response to Peg‐IFN, even though the treatment was provided only throughout a 24‐week period. Conclusion: To our knowledge, this is the first report regarding the successful result obtained by using Peg‐IFN as a treatment for a chronically HBV‐infected patient carrying HBsAg immune escape mutants.