TY  - JOUR
A1  - Anastasiou, Olympia Evdoxia
A1  - Theissen, Martin
A1  - Verheyen, Jens
A1  - Bleekmann, Barbara
A1  - Wedemeyer, Heiner
A1  - Widera, Marek
A1  - Ciesek, Sandra
T1  - Clinical and virological aspects of HBV reactivation: a focus on acute liver failure
T2  - Viruses
N2  - Hepatitis B virus (HBV) reactivation in immunosuppressed patients can cause considerable morbidity and mortality. The aim of our study was to evaluate factors associated with acute liver failure (ALF) in HBV reactivation. Clinical, laboratory, and virological data of 87 patients with HBV reactivation were analyzed retrospectively. Teno torque virus (TTV) plasma loads were measured as a measure of immune competence. HBV genomes isolated from 47 patients were analyzed by next-generation sequencing. A functional analysis of identified HBsAg mutants was performed. In patients with ALF the diagnosis was significantly later confirmed than in the non-ALF group. Patients diagnosed during immunosuppression had a milder clinical course compared to later diagnosed patients (p = 0.018, OR = 4.17). TTV viral loads did not differ significantly between the two groups. The HBV genomes isolated from ALF patients had higher viral complexity. A mutation in C-region of HBsAg (L216*), was associated with reduced HBsAg production and secretion. Patients diagnosed with HBV reactivation during immunosuppression had a milder clinical course compared to patients diagnosed during immune reconstitution. ALF was associated with higher viral complexity. An HBsAg mutation (L216*) was found to be more frequent in ALF patients and was associated with reduced HBsAg production and secretion.
KW  - hepatitis B
KW  - HBV
KW  - reactivation
KW  - NGS
KW  - ALF
KW  - acute liver failure
Y1  - 2019
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/57200
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-572008
SN  - 1999-4915
VL  - 11
IS  - Nr. 9, Art. 863
PB  - MDPI
CY  - Basel
ER  -