Journal of Gastroenterology

, Volume 42, Issue 2, pp 168–175

A male patient with severe acute hepatitis who was domestically infected with a genotype H hepatitis B virus in Iwate, Japan

  • Ichiro Kumagai
  • Koichi Abe
  • Takayoshi Oikawa
  • Akihiro Sato
  • Shinichiro Sato
  • Ryujin Endo
  • Yasuhiro Takikawa
  • Kazuyuki Suzuki
  • Tomoyuki Masuda
  • Shigehiko Sainokami
  • Kazunori Endo
  • Masaharu Takahashi
  • Hiroaki Okamoto
Case report

DOI: 10.1007/s00535-006-1963-2

Cite this article as:
Kumagai, I., Abe, K., Oikawa, T. et al. J Gastroenterol (2007) 42: 168. doi:10.1007/s00535-006-1963-2

Abstract

Although all eight genotypes of hepatitis B virus (HBV) strains are circulating in Japan, no cases of acute hepatitis with foreign HBV strains of genotype H have thus far been reported in Japan. Here, we report a 35-year-old Japanese patient with severe acute hepatitis who was domestically infected with genotype H HBV. On admission, he had a high HBV load of 1.0 × 109 copies/ml, elevated levels of total bilirubin (7.0 mg/dl) and alanine aminotransferase (3606 IU/l), and reduced prothrombin activity of 39.0%. The HB-JAIW05 isolate obtained in the present study was composed of 3215 nucleotides and had the highest similarity of 99.7% with the reported genotype H HBV isolate recovered from a Japanese blood donor. The HB-JAIW05 isolate had neither precore (A1896) nor core promoter (T1762/A1764) mutations. However, upon comparison with the consensus sequence of ten reported HBV isolates of the same genotype, the HB-JAIW05 isolate had 17 nucleotide substitutions including five missense mutations in the P gene, which may be related to vigorous replication of HBV in this case. He had no history of traveling abroad, but had had extramarital sexual contact with two Japanese women living in Iwate, Japan, 2 weeks and 2 months before the disease onset, respectively. Our results suggest that rare HBV genotypes such as H may be spreading in Japan via sexual contact. Further molecular epidemiological studies on HBV to clarify the exact changing profiles of de novo HBV infection in Japan in relation to genotype and genomic variability are warranted.

Key words

severe acute hepatitis hepatitis B virus genotype H 

Copyright information

© Springer-Verlag Tokyo 2007

Authors and Affiliations

  • Ichiro Kumagai
    • 1
  • Koichi Abe
    • 1
  • Takayoshi Oikawa
    • 1
  • Akihiro Sato
    • 1
  • Shinichiro Sato
    • 1
  • Ryujin Endo
    • 1
  • Yasuhiro Takikawa
    • 1
  • Kazuyuki Suzuki
    • 1
  • Tomoyuki Masuda
    • 2
  • Shigehiko Sainokami
    • 1
    • 3
  • Kazunori Endo
    • 4
  • Masaharu Takahashi
    • 4
  • Hiroaki Okamoto
    • 4
  1. 1.First Department of Internal MedicineIwate Medical UniversityIwateJapan
  2. 2.Second Department of PathologyIwate Medical UniversityIwateJapan
  3. 3.Division of Liver DiseasesOshu City HospitalIwateJapan
  4. 4.Division of Virology, Department of Infection and ImmunityJichi Medical University School of MedicineTochigiJapan

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