Fulminant hepatitis B associated with a specific insertion in the basal core promoter region of hepatitis B virus DNA after immunosuppressive treatment.

Gérolami, René; Henry, Mireille; Borentain, Patrick; Colson, Philippe; Botta, Danièle; Tamalet, Catherine · Clin Infect Dis · 2005

case_report · Level V

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Abstract

We report a case of hepatitis B virus reactivation that occurred after immunosuppressive treatment in a hepatitis B surface antigen-negative patient with detectable antibodies to hepatitis B core antigen and hepatitis B surface antigen. Sequence analysis revealed an 11-bp insertion in the core promoter region of hepatitis virus DNA, creating a novel hepatocyte nuclear factor-1 binding site. This led to enhanced viral replication and fulminant hepatitis.

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