Open AccessHepatitis B virus subgenotype F3 reactivation with vaccine escape mutations: A case report and review of the literature
Author(s) -
Stefan Schlabe,
Kathrin van Bremen,
Souhaib Aldabbagh,
Dieter Glebe,
Corinna M. Bremer,
Tobias A. Marsen,
W. Mellin,
Veronica Di Cristanziano,
Anna Maria EisHübinger,
Ulrich Spengler
Publication year - 2018
Publication title -
world journal of hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.913
H-Index - 55
ISSN - 1948-5182
DOI - 10.4254/wjh.v10.i7.509
Subject(s) - medicine , hepatitis b virus , virology , entecavir , vaccination , hbsag , transmission (telecommunications) , hepatitis b , virus , immunology , epidemiology , kidney transplantation , transplantation , lamivudine , electrical engineering , engineering
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 HBsAg-negative prior to vaccination 6 years before transplantation. The reactivated virus was HBV genotype F3 with vaccine escape mutations G145R, P120Q, and Q129P. 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.