Reactivation of precore variant hepatitis B virus in a child with severe aplastic anaemia

P. R. Smith, R. Zampino, C. Gutteridge, P. Karayiannis, C. Aitken

Research output: Contribution to journalArticlepeer-review

Abstract

Reactivation of hepatitis B e antigen (HBeAg) negative chronic hepatitis B virus (HBV) infection due to selection of precore variant virus is an uncommon complication of previous hepatitis B infection, and virtually unrecognised in children and adolescents. A child who had received treatment with methylprednisolone and antilymphocyte globulin for severe aplastic anaemia developed high levels of detectable HBV DNA associated with hepatitis B e antibody (anti-HBe) positivity. HBV DNA was extracted, amplified and the core and precore regions sequenced from 2 samples. A mixture of wild-type and the precore variants A 1896 and A 1899 was detected in both samples, with the wild-type predominating in the second sample. Reinfection was excluded by phylogenetic analysis using Phylip and the neighbour-joining method. Precore variant Hepatitis B virus can be transmitted to children as a primary infection, and it is important that aggressive liver disease, particularly in the presence of the anti-HBe phenotype, be investigated. Further studies are needed to determine the frequency of these variants.

Original languageEnglish
Pages (from-to)470-472
Number of pages3
JournalJournal of Medical Virology
Volume65
Issue number3
DOIs
Publication statusPublished - 2001

Keywords

  • HBV
  • Immunosuppression
  • Mutation
  • Precore sequence

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