Abstract
Presented here is the first report of clinical reactivation of hepatitis B virus (HBV) in an HIV-infected patient who previously had anti-HBc as the only serological marker of past infection (anti-HBc alone). Reactivation occurred after lamivudine was removed from the patient’s antiretroviral treatment regimen due to lack of virological response. HIV-infected patients frequently present anti-HBc alone, and in some cases this serological profile is associated with occult HBV infection. The current case demonstrates the importance of ruling out the possibility of occult infection in this patient group.
Similar content being viewed by others
References
Rutsgi V, Hoofnagle J, Guerin J et al (1984) Hepatitis B infection in the acquired immunodeficiency syndrome. Ann Intern Med 101:795–797
Bessesen M, Ives D, Condreay L, Lawrence S, Sherman KE (1999) Chronic active hepatitis B exacerbation in human immunodeficency virus-infected patients following development of resistance to or withdrawal of lamivudine. Clin Infect Dis 28:1032–1035
Altfeld M, Rockstroh JK, Addo M, Kupfer B, Pult I, Will H, Spengler U (1998) Reactivation of hepatitis B in a long-term anti-HBs-positive patient with AIDS following lamivudine withdrawal. J Hepatol 29:306–309
Neau D, Schvoerer E, Robert D, Dubois F, Dutronc H, Fleury HJ, Ragnaud JM (2000) Hepatitis B exacerbation with a precore mutant virus following withdrawal of lamivudine in a human immunodeficiency virus-infected patient. J Infect 41:192–194
Hadler SC, Murphy BL, Schable CA, Heyward WL, Francis DP, Kane MA (1984) Epidemiological analysis of the significance of low-positive test results for antibody to hepatitis B surface and core antigens. J Clin Microbiol 19:521–525
Joller-Jemelka HI, Wicki AN, Grob PJ (1994) Detection of HBs antigen in “anti-HBc alone” positive sera. J Hepatol 21:269–272
Grob P, Jilg W, Bornhak H et al (2000) Serological pattern “anti-HBc alone” report on a work-shop. J Med Virol 62:450–455
Gandhi RT, Wurcel A, Lee H, McGovern B, Boczanowski M, Gerwin R, Corcoran CP, Szczepiorkowski Z, Toner S, Cohen DE, Sax PE, Ukomadu C (2003) Isolated antibody to hepatitis B core antigen in human immunodeficiency virus type-1-infected individuals. Clin Infect Dis 36:1602–1605
Krugman S, Overby LR, Mushahwar IK et al (1979) Viral hepatitis, type B. Studies on natural history and prevention re-examined. N Engl J Med 300:101
Bani-Sadr F, Maillard A, Ponscarme D, Scieux C, Molina JM (2003) Reactivation of HBV replication in HIV-HBV infected patients. Am J Med 114:768–769
Piroth L, Binquet C, Vergne M, Minello A, Livry C, Bour JB, Buisson M, Duong M, Grappin M, Portier H, Chavanet P (2002) The evolution of hepatitis B virus serological patterns and the clinical relevance of isolated antibodies to hepatitis B core antigen in HIV infected patients. J Hepatol 36:681–686
Hofer M, Joller-Jemelka HJ, Grob PJ, Luthy R, Opravil M (1998) Frequent chronic hepatitis B virus infection in HIV-infected patients positive for antibody to hepatitis B core antigen only. Eur J Clin Microbiol Infect Dis 17:6–13
Hino K, Basuni AA, Ireland J, Newell A, Mphahlele J, Smit EJ, Ngui SL, Teo CG, Carman WF (2002) Reappearance of hepatitis B surface antigen in immunocompromised individuals. Reinfection or reactivation? Dig Dis Sci 47:415–418
Manegold C, Hannoun C, Wywiol A, Dietrich M, Polywka S, Chiwakata CB, Gunther S (2001) Reactivation of hepatitis B virus replication accompanied by acute hepatitis in patients receiving highly active antiretroviral therapy. Clin Infect Dis 32:144–148
Thio CL, Seaberg EC, Skolasky R Jr, Phair J, Visscher B, Munoz A, Thomas DL, Multicenter AIDS Cohort Study (2002) HIV-1, hepatitis B virus, and risk of liver-related mortality in the Multicenter Cohort Study (MACS). Lancet 360:1921–1926
Lascar RM, Gilson RJ, Lopes AR, Bertoletti A, Maini MK (2003) Reconstitution of hepatitis B virus (HBV)-specific T cell responses with treatment of human immunodeficiency virus/HBV coinfection. J Infect Dis 188:1815–1819
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Chamorro, A.J., Casado, J.L., Bellido, D. et al. Reactivation of hepatitis B in an HIV-infected patient with antibodies against hepatitis B core antigen as the only serological marker. Eur J Clin Microbiol Infect Dis 24, 492–494 (2005). https://doi.org/10.1007/s10096-005-1355-1
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10096-005-1355-1