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Published on: August 31, 2014
Atypical hepatitis B surface antigen escape mutations in an HIV-positive patient in South Africa
Menzi B Nkosi1,2, Marije van Schalkwyk3, Tongai G Maponga1,2
1Division of Medical Virology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
Abstract:
A 44-year-old woman with human immunodeficiency virus (HIV), chronic kidney disease and chronic diarrhoea presented with worsening gastrointestinal symptoms and renal impairment. Despite reported adherence, she had HIV viraemia and atypical hepatitis B serology (absence of hepatitis B core antibody and co-existence of hepatitis B surface antigen (HBsAg) and hepatitis B surface antibody) with high hepatitis B virus DNA. Whole genome sequencing of hepatitis B virus was performed using Oxford Nanopore Technologies sequencing on the Oxford Nanopore Technologies GridION (ONT, Oxford, United Kingdom). Genotype A infection with HBsAg immune escape mutations D144G/G145E was identified, without drug-resistance mutations.
Contribution:
Findings are most consistent with hepatitis B virus reactivation following prior natural infection and subsequent loss of immune control.
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