Pitfall of hepatitis B surface antigen testing in a kidney transplant recipient presenting hepatitis B reactivation.

نویسندگان

  • Pauline Romanet
  • Henri Vacher-Coponat
  • Valérie Moal
  • Danielle Botta-Fridlund
  • Anne Motte
  • Philippe Colson
چکیده

Diagnosis of hepatitis B virus (HBV) infection based on hepatitis B surface antigen (HBsAg) detection can be hampered in the setting of HBV reactivation in immunocompromized patients with prior serology indicating past cured infection, and can be associated with severe or fulminant and fatal hepatitis. We present a case of HBV reactivation in a renal transplant patient in whom HBsAg failed to be confirmed as a true positive result. One year after transplantation, systematic testing showed HBsAg positivity with a titer at 244 pg/mL, anti-hepatitis B core antibody and concurrent anti-hepatitis B surface antibody positivity. Confirmation of HBsAg detection by seroneutralization did not confirm HBsAg positivity, indicating that HBsAg detection was a false positive result. Notwithstanding, HBV DNA titer in serum was concurrently 8.6 Log IU/mL. HBV DNA sequencing showed a genotype D and several amino acid substitutions within HBsAg, including some previously involved in impaired diagnosis and altered immunogenicity. Although no perturbation of liver biochemical markers was observed, treatment with tenofovir was introduced. One month later, HBV DNA level had decreased by 2.6 Log IU/mL and no clinical and biochemical symptoms of hepatitis had occurred. The present case underlines that serologic diagnosis of HBV reactivation can be tricky in transplant recipients with a prior serology indicating past HBV infection. This prompts to perform HBV DNA testing in case of positive HBsAg testing, regardless of the result of neutralization by anti-HBs antibodies.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

A Case of Hairy Cell Leukemia Associated with Hepatitis B Surface (HBs) Antigenemia and Concurrent Hepatitis C Virus (HCV) Seropositivity

Literature review shows that hepatitis C infection may increase the risk of non-hodgkin lymphoma. Reactivation of hepatitis B infection has been reported in patients with hairy cell leukemia after chemotherapy and/or splenectomy. We present hepatitis B surface (HBs) antigenemia and concurrent hepatitis C virus (HCV) seropositivity in a case of hairy cell leukemia. Key Words: Hairy cell leukemi...

متن کامل

Construction of Hybrid Gene of Hepatitis B Surface Antigen Carrying Heat-Stable Enterotoxin of Escherichia coli and Its Expression in Mammalian Cell Line

Hepatitis B surface antigen is the first genetically engineered vaccine licensed for human use. Various strategies have been proposed to obtain a vaccine that would bypass the need for injection. In this study, a non-toxic portion of heat-stable enterotoxin of Escherichia coli that is capable of adhering to epithelial cells was inserted at amino acid position 112 of hepatitis surface antigen. T...

متن کامل

Priming Hepatitis B Surface (HBsAg)- and Core Antigen (HBcAg)-Specific Immune Responses by Chimeric, HBcAg with a HBsAg ‘a’ Determinant

We developed an immunogen to stimulate multivalent immunity against hepatitis B surface antigen (HBsAg) and hepatitis B core antigens (HBcAg). Immune responses specific for both HBsAg and HBcAg play an important role in controlling the infection. HBsAg-specific antibodies mediate elimination of virions at an early stage of infection and prevent the spread of virus. The immunogen was constructed...

متن کامل

Prevalence of Hepatitis B Surface Antigen and Associated Risk Factors with Hepatitis B Infection among Pregnant Women in Northeast of Iran

Background and Aims: Almost 350 million people worldwide are carriers of hepatitis B virus. The rate of chronic carriers in Iran is about 3%.  Therefore Iran is categorized as a country with moderate rate of infection with this virus. In developing countries, transmission from mother to fetus and newborn is considered as one of the main routes of transmission. So, this study investigated t...

متن کامل

Prevention of Hepatitis B Virus Reactivation in Kidney Transplant Recipients

BACKGROUND AND OBJECTIVE: Hepatitis B virus (HBV) reactivation is a major risk factor for hepatic dysfunction, acute or chronic hepatitis, cirrhosis, or hepatocellular carcinoma after kidney transplantation (KTP). The present article summarizes some of published articles about prevention of HBV reactivation in renal transplant recipients METHODS: Many articles published in English language as f...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:
  • Clinics and research in hepatology and gastroenterology

دوره 35 10  شماره 

صفحات  -

تاریخ انتشار 2011