Acute hepatitis B of genotype H resulting in persistent infection

作者：Yamada Norie; Shigefuku Ryuta; Sugiyama Ryuichi; Kobayashi Minoru; Ikeda Hiroki; Takahashi Hideaki; Okuse Chiaki; Suzuki Michihiro; Itoh Fumio; Yotsuyanagi Hiroshi; Yasuda Kiyomi; Moriya Kyoji; Koike Kazuhiko; Wakita Takaji; Kato Takanobu^*

来源：World Journal of Gastroenterology, 2014, 20(11): 3044-3049.

DOI：10.3748/wjg.v20.i11.3044

• Acute hepatitis
• Chronic hepatitis
• Genotyping
• Hepatitis B virus
• Single nucleotide polymorphisms

A 47-year-old man presented with general fatigue and dark urine. The laboratory data showed increased levels of hepatic transaminases. The patient was positive for hepatitis B virus (HBV) markers and negative for antihuman immunodeficiency virus. The HBV-DNA titer was set to 7.7 log copies/mL. The patient was diagnosed with acute hepatitis B. The HBV infection route was obscure. The serum levels of hepatic transaminases decreased to normal ranges without any treatment, but the HBV-DNA status was maintained for at least 26 mo, indicating the presence of persistent infection. We isolated HBV from the acute-phase serum and determined the genome sequence. A phylogenetic analysis revealed that the isolated HBV was genotype H. In this patient, the elevated peak level of HBV-DNA and the risk alleles at human genome single nucleotide polymorphisms s3077 and rs9277535 in the human leukocyte antigen-DP locus were considered to be risk factors for chronic infection. This case suggests that there is a risk of persistent infection by HBV genotype H following acute hepatitis; further cases of HBV genotype H infection must be identified and characterized. Thus, the complete determination of the HBV genotype may be essential during routine clinical care of acute hepatitis B outpatients.

• 出版日期2014-3-21