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Reactivation of hepatitis B in a long-term anti-HBs-positive patient with AIDS following lamivudine withdrawal

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Reactivation of hepatitis B in a long-term anti-HBs-positive patient with AIDS following lamivudine withdrawal. / Altfeld, M; Rockstroh, J K; Addo, Marylyn M.; Kupfer, B; Pult, I; Will, Hans; Spengler, U.

In: J HEPATOL, Vol. 29, No. 2, 08.1998, p. 306-9.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Altfeld, M, Rockstroh, JK, Addo, MM, Kupfer, B, Pult, I, Will, H & Spengler, U 1998, 'Reactivation of hepatitis B in a long-term anti-HBs-positive patient with AIDS following lamivudine withdrawal', J HEPATOL, vol. 29, no. 2, pp. 306-9. https://doi.org/10.1016/s0168-8278(98)80017-2

APA

Altfeld, M., Rockstroh, J. K., Addo, M. M., Kupfer, B., Pult, I., Will, H., & Spengler, U. (1998). Reactivation of hepatitis B in a long-term anti-HBs-positive patient with AIDS following lamivudine withdrawal. J HEPATOL, 29(2), 306-9. https://doi.org/10.1016/s0168-8278(98)80017-2

Vancouver

Altfeld M, Rockstroh JK, Addo MM, Kupfer B, Pult I, Will H et al. Reactivation of hepatitis B in a long-term anti-HBs-positive patient with AIDS following lamivudine withdrawal. J HEPATOL. 1998 Aug;29(2):306-9. https://doi.org/10.1016/s0168-8278(98)80017-2

Bibtex

@article{75a4a6a5581e478fa8aa6155c5686f37,
title = "Reactivation of hepatitis B in a long-term anti-HBs-positive patient with AIDS following lamivudine withdrawal",
abstract = "BACKGROUND/AIMS: In HIV-infected patients, who have recovered completely from an acute hepatitis B infection and become anti-HBs positive, hepatitis B infection may be reactivated after progression to AIDS.CASE REPORT: We present the case of a homosexual male patient with AIDS who developed clinical and serological reactivation of hepatitis B with detectable HBV-DNA 18 years after complete recovery from acute hepatitis B infection. Prior to reactivation, antiretroviral triple therapy including lamivudine was changed to therapy without lamivudine. After reintroduction of lamivudine in the triple therapy, HBV-DNA became undetectable and the patient lost HBsAg and again developed anti-HBs antibodies.CONCLUSION: The hepatitis B in this patient can be explained best by reactivation of persistent HBV infection, possibly because of transient decline in antibodies against HBs-antigen due to a reduction in CD4+ lymphocyte numbers and B cell dysfunction. This observation points to the clinical relevance of HBV persistence in serum and blood cells of anti-HBs-positive subjects for many years after recovery from acute hepatitis B infection. The possible role of lamivudine withdrawal which immediately preceded HBV breakthrough in our patient is noteworthy. Regular monitoring of markers of HBV infection, including HBV-DNA, in patients with AIDS appears justified after discontinuation of lamivudine.",
keywords = "Acquired Immunodeficiency Syndrome/complications, Anti-HIV Agents/administration & dosage, DNA, Viral/blood, Drug Administration Schedule, Hepatitis B/complications, Hepatitis B Surface Antigens/blood, Hepatitis B virus/growth & development, Homosexuality, Male, Humans, Lamivudine/administration & dosage, Male, Middle Aged, Recurrence, Virus Activation",
author = "M Altfeld and Rockstroh, {J K} and Addo, {Marylyn M.} and B Kupfer and I Pult and Hans Will and U Spengler",
year = "1998",
month = aug,
doi = "10.1016/s0168-8278(98)80017-2",
language = "English",
volume = "29",
pages = "306--9",
journal = "J HEPATOL",
issn = "0168-8278",
publisher = "Elsevier",
number = "2",

}

RIS

TY - JOUR

T1 - Reactivation of hepatitis B in a long-term anti-HBs-positive patient with AIDS following lamivudine withdrawal

AU - Altfeld, M

AU - Rockstroh, J K

AU - Addo, Marylyn M.

AU - Kupfer, B

AU - Pult, I

AU - Will, Hans

AU - Spengler, U

PY - 1998/8

Y1 - 1998/8

N2 - BACKGROUND/AIMS: In HIV-infected patients, who have recovered completely from an acute hepatitis B infection and become anti-HBs positive, hepatitis B infection may be reactivated after progression to AIDS.CASE REPORT: We present the case of a homosexual male patient with AIDS who developed clinical and serological reactivation of hepatitis B with detectable HBV-DNA 18 years after complete recovery from acute hepatitis B infection. Prior to reactivation, antiretroviral triple therapy including lamivudine was changed to therapy without lamivudine. After reintroduction of lamivudine in the triple therapy, HBV-DNA became undetectable and the patient lost HBsAg and again developed anti-HBs antibodies.CONCLUSION: The hepatitis B in this patient can be explained best by reactivation of persistent HBV infection, possibly because of transient decline in antibodies against HBs-antigen due to a reduction in CD4+ lymphocyte numbers and B cell dysfunction. This observation points to the clinical relevance of HBV persistence in serum and blood cells of anti-HBs-positive subjects for many years after recovery from acute hepatitis B infection. The possible role of lamivudine withdrawal which immediately preceded HBV breakthrough in our patient is noteworthy. Regular monitoring of markers of HBV infection, including HBV-DNA, in patients with AIDS appears justified after discontinuation of lamivudine.

AB - BACKGROUND/AIMS: In HIV-infected patients, who have recovered completely from an acute hepatitis B infection and become anti-HBs positive, hepatitis B infection may be reactivated after progression to AIDS.CASE REPORT: We present the case of a homosexual male patient with AIDS who developed clinical and serological reactivation of hepatitis B with detectable HBV-DNA 18 years after complete recovery from acute hepatitis B infection. Prior to reactivation, antiretroviral triple therapy including lamivudine was changed to therapy without lamivudine. After reintroduction of lamivudine in the triple therapy, HBV-DNA became undetectable and the patient lost HBsAg and again developed anti-HBs antibodies.CONCLUSION: The hepatitis B in this patient can be explained best by reactivation of persistent HBV infection, possibly because of transient decline in antibodies against HBs-antigen due to a reduction in CD4+ lymphocyte numbers and B cell dysfunction. This observation points to the clinical relevance of HBV persistence in serum and blood cells of anti-HBs-positive subjects for many years after recovery from acute hepatitis B infection. The possible role of lamivudine withdrawal which immediately preceded HBV breakthrough in our patient is noteworthy. Regular monitoring of markers of HBV infection, including HBV-DNA, in patients with AIDS appears justified after discontinuation of lamivudine.

KW - Acquired Immunodeficiency Syndrome/complications

KW - Anti-HIV Agents/administration & dosage

KW - DNA, Viral/blood

KW - Drug Administration Schedule

KW - Hepatitis B/complications

KW - Hepatitis B Surface Antigens/blood

KW - Hepatitis B virus/growth & development

KW - Homosexuality, Male

KW - Humans

KW - Lamivudine/administration & dosage

KW - Male

KW - Middle Aged

KW - Recurrence

KW - Virus Activation

U2 - 10.1016/s0168-8278(98)80017-2

DO - 10.1016/s0168-8278(98)80017-2

M3 - SCORING: Journal article

C2 - 9722213

VL - 29

SP - 306

EP - 309

JO - J HEPATOL

JF - J HEPATOL

SN - 0168-8278

IS - 2

ER -