Summary
The case of a young man effected by homozygous beta-thalassemia is reported who had serologic findings of a prior HBV infection and who presented with clinical and biochemical acute HBV infection probably caused by HBV reactivation after allogeneic bone marrow transplantation. The patient's clinical history suggests that HBV can persist without serological findings of HBsAg and HBV-DNA in persons previously infected by HBV and that HBV reactivation can occur 2 years after allogeneic bone marrow transplantation, as a result of immunosuppressive therapy or an HCV activation.
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Milich, D. R.: T and B cell recognition of hepatitis B viral antigens. Immunol. Today 9 (1988) 380–386.
Davis, G. L., Hoofnagle, J. H.: Reactivation of chronic type B hepatitis presenting as viral hepatitis. Ann. Intern. Med. 102 (1985) 762–765.
Fan, F. S., Tzeng, C. H., Yale, H. M., Chen, P. M.: Reverse seroconversion of hepatitis B virus infectious status after allogeneic bone marrow transplantation from a carrier donor. Bone Marrow Transplant 10 (1992) 189–191.
Hoofnagle, J. H., Dusheiko, G. M., Schafer, D. F., Jones, E. A., Micetich, K. C., Young, R. C., Costa, J.: Reactivation of chronic hepatitis B virus infection by cancer chemotherapy. Ann. Intern. Med. 96 (1982) 447–449.
Lucarelli, G., Galimberti, M., Polchi, P., Angelucci, E., Baronciani, E., Durazzi, S. M. T., Giardini, C., Nicolini, G., Politi, P.: Bone marrow transplantation in thalassemia. In:Rebulla, P., Fessas, P. H. (eds.): Thalassemia 1990, Proceedings of the 5th Annual Meeting of the Cooleycare Group, Athens, June 14–15, 1990, pp. 87–90.
Raimondo, G., Schneider, R., Siemler, M., Smedile, V..,Rodinò, G., Will, H.: A new hepatitis B virus variant in a chronic carrier with multiple episodes of viral reactivation and acute hepatitis. Virology 179 (1990) 64–68.
Young, K., Resnick, R., Myers, T.: Detection of hepatitis C virus RNA by a combined reverse transcriptase-polymerase chain reaction assay. J. Clin. Microbiol. 31 (1993) 882–886.
Degos, F., Lugassy, C., Degott, C., Debure, A., Carnot, F., Thiers, V., Tiollais, P., Kreis, H., Bréchot, C.: Hepatitis B virus and hepatitis B-related viral infection in renal transplant recipients. Gastroenterology 94 (1988) 151–156.
Vergani, D., Locasciulli, A., Masera, G., Alberti, A., Moroni, G., Dee, D. E. H., Portmann, B., Mieli-Vergani, G., Eddleston, A. L. W. F.: Histological evidence of hepatitis B virus infection with negative serology in children with acute leukemia who develop chronic liver disease. Lancet i (1982) 361–364.
Bréchot, C., Degos, F., Lugassy, C., Thiers, V., Zafrani, S., Franco, D., Bismuth, H., Trépo, C., Benhamon, J. P., Wands, J., Isselbacher, K., Tiollais, P., Berthelot, P.: Hepatitis B virus DNA in patients with chronic liver disease and negative tests for hepatitis B surface antigen. N. Engl. J. Med. 312 (1985) 270–276.
Tsiquaye, K. N., Portmann, B., Tovey, G., Kessler, H., Shanlion, Hu., Xiao-zhen, Lu., Zuckerman, A. J., Craske, J., Williams, R.: Non-A, non-B hepatitis in persistent carriers of hepatitis B virus. J. Med. Virol. 11 (1983) 179–189.
Wang, J. T., Wang, T. H., Sheu, J. C., Lin, J. T., Wang, C. Y., Chen, D. S.: Post-transfusion hepatitis revisited by hepatitis C antibody assays and polymerase chain reaction. Gastroenterology 103 (1992) 609–616.
Ohkawa, K., Hayoshi, N., Yuki, N., Hagiwara, H., Kato, M., Yamamoto, K., Eguchi, H., Fusamoto, H., Masuzawa, M., Kamada, T.: Hepatitis C virus antibody and hepatitis C replication in chronic hepatitis B patients. J. Hepatol. 21 (1994) 509–514.
Nagington, J., Cossart, Y. E., Cohen, B. J.: Reactivation of hepatitis B after transplantation operations. Lancet i (1977) 558–560.
Villa, E., Theodori, A., Portmann, B., Eddleston, A. L. W. F., Williams, R.: Reactivation of hepatitis B virus infection in two patients: immunofluorescence studies of liver tissue. Gastroenterology 80 (1981) 1048–1053.
Locasciulli, A., Bacigalupo, A., Van Lint, M. T., Chemello, L., Pontisso, P., Occhini, D., Uderzo, C., Schulman, H. M., Portmann, B., Marmont, A. M., Alberti, A.: Hepatitis B virus (HBV) infection and liver disease after allogeneic bone marrow transplantation: a report of 30 cases. Bone Marrow Transplant 6 (1990) 25–29.
Locasciulli, A., Santamaria, M., Masera, G., Schiavon, E., Alberti, A., Realdi, S.: Hepatitis B virus markers in children with acute leukemia: the effect of chemotherapy. J. Med. Virol. 15 (1985) 29–33.
Galbraith, R. M., Eddleston, A. L. W. F., Williams, R., Zuckerman, A. J., Gagshawe, K. D.: Fulminant hepatic failure in leukemia and choriocarcinoma related to withdrawal of cytotoxic drug therapy. Lancet ii (1975) 528–530.
Martin, B. A., Rowe, J. M., Konides, P. A., Di Persio, J. F.: Hepatitis B reactivation following allogenic bone marrow transplantation: case report and review of the literature. Bone Marrow Transplant 15 (1995) 145–148.
Blum, H. E., Offenspeger, W. B., Walter, E., Offenspeger, S., Gerok, W.: Latent hepatitis B virus infection with full length viral genome in a patient serologically immune to hepatitis B virus infection. Liver 8 (1988) 307–316.
Rasenack, J. W., Schlayer, H. J., Hettler, F., Peters, T., Preisler-Adams, S., Gerok, W.: Hepatitis B virus infection without immunological markers after open-heart surgery. Lancet i (1995) 355–357.
Raimondo, G., Rodino, G., Smedile, V., Brancatelli, S., Villari, D., Longo, S., Squadrito, G.: Hepatitis B virus (HBV) markers and HBV-DNA in serum and liver tissue of patients with acute exacerbation of chronic type B hepatitis. J. Hepatol. 10 (1990) 271–273.
Zuckerman, A. J., Harrison, T. J., Oon, C. J.: Mutations in the S region of hepatitis B virus. Lancet i (1994) 737–738.
Hoofnagle, J. H., Gerety, R. J., Ni, L. Y., Barker, L. F.: Antibody to hepatitis B core antigen: a sensitive indicator of hepatitis B virus replication. N. Engl. J. Med. 290 (1974) 1336–1340.
Hoofnagle, J. H., Seeff, L. B., Buskell Bales, Z., Zimmerman, H. J. and the Veterans Administration Hepatitis Cooperative Study Group: Type B hepatitis after transfusion with blood containing antibody to hepatitis B core antigen. N. Engl. J. Med. 298 (1978) 1379–1383.
Koike, K., Tino, S., Kurai, K., Mitomura, K., Endo, Y., Oka, K.: IgM anti-HBc in anti-HBe positive chronic type B hepatitis with acute exacerbation. Hepatology 7 (1987) 573–576.
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Volti, S.L., Pizzarelli, G., Galimberti, M. et al. Clinical and biochemical reactivation of HBV infection in a thalassemic patient after bone marrow transplantation. Infection 26, 58–60 (1998). https://doi.org/10.1007/BF02768759
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DOI: https://doi.org/10.1007/BF02768759