Clinical and virological aspects of HBV reactivation: a focus on acute liver failure

  • 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.

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Author:Olympia Evdoxia Anastasiou, Martin Theissen, Jens Verheyen, Barbara Bleekmann, Heiner WedemeyerORCiDGND, Marek WideraORCiDGND, Sandra CiesekORCiDGND
Parent Title (English):Viruses
Place of publication:Basel
Document Type:Article
Date of Publication (online):2019/09/16
Date of first Publication:2019/09/16
Publishing Institution:Universit├Ątsbibliothek Johann Christian Senckenberg
Release Date:2020/12/08
Tag:ALF; HBV; NGS; acute liver failure; hepatitis B; reactivation
Issue:Nr. 9, Art. 863
Page Number:14
Institutes:Medizin / Medizin
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCreative Commons - Namensnennung 4.0