{"title":"在存在高水平的抗hbs抗体的情况下，长期存在的、未确诊的、高度复制的乙型肝炎病毒再激活。","authors":"Mahdi Ouafi, Alexandre Réguème, Stéphane Chevaliez, Emmanuel Faure, Aurélie Guigon, Magali Bouvier-Alias, Valérie Canva, Didier Hober, Laurence Bocket, Enagnon Kazali Alidjinou","doi":"10.1093/labmed/lmaf003","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Kidney transplant recipients are among the populations at risk for Hepatitis B Virus (HBV) reactivation, and close monitoring is needed for its early detection.</p><p><strong>Methods: </strong>We describe a case of HBV reactivation in a patient who underwent kidney transplantation more than 30 years ago, with a known serological profile of past HBV infection.</p><p><strong>Results: </strong>Reactivation occurred as a highly replicative infection that went undiagnosed for 7 years due to negative results for HB surface antigen (HBsAg) and high levels of anti-HBs antibodies. Viral genome sequencing showed a high number of mutations in the major hydrophilic region of HBsAg that could explain such a profile.</p><p><strong>Discussion: </strong>This case highlights the usefulness of frequent and systematic HBV viral load testing in patients at risk of reactivation, with anti-hepatitis B core antibodies, regardless of HBsAg detection, aminotransferases, and anti-HBs antibody levels.</p>","PeriodicalId":94124,"journal":{"name":"Laboratory medicine","volume":" ","pages":"577-581"},"PeriodicalIF":1.0000,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Longstanding, undiagnosed, highly replicative hepatitis B virus reactivation in the presence of high levels of anti-HBs antibodies.\",\"authors\":\"Mahdi Ouafi, Alexandre Réguème, Stéphane Chevaliez, Emmanuel Faure, Aurélie Guigon, Magali Bouvier-Alias, Valérie Canva, Didier Hober, Laurence Bocket, Enagnon Kazali Alidjinou\",\"doi\":\"10.1093/labmed/lmaf003\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Kidney transplant recipients are among the populations at risk for Hepatitis B Virus (HBV) reactivation, and close monitoring is needed for its early detection.</p><p><strong>Methods: </strong>We describe a case of HBV reactivation in a patient who underwent kidney transplantation more than 30 years ago, with a known serological profile of past HBV infection.</p><p><strong>Results: </strong>Reactivation occurred as a highly replicative infection that went undiagnosed for 7 years due to negative results for HB surface antigen (HBsAg) and high levels of anti-HBs antibodies. Viral genome sequencing showed a high number of mutations in the major hydrophilic region of HBsAg that could explain such a profile.</p><p><strong>Discussion: </strong>This case highlights the usefulness of frequent and systematic HBV viral load testing in patients at risk of reactivation, with anti-hepatitis B core antibodies, regardless of HBsAg detection, aminotransferases, and anti-HBs antibody levels.</p>\",\"PeriodicalId\":94124,\"journal\":{\"name\":\"Laboratory medicine\",\"volume\":\" \",\"pages\":\"577-581\"},\"PeriodicalIF\":1.0000,\"publicationDate\":\"2025-09-08\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Laboratory medicine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1093/labmed/lmaf003\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Laboratory medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1093/labmed/lmaf003","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Longstanding, undiagnosed, highly replicative hepatitis B virus reactivation in the presence of high levels of anti-HBs antibodies.
Introduction: Kidney transplant recipients are among the populations at risk for Hepatitis B Virus (HBV) reactivation, and close monitoring is needed for its early detection.
Methods: We describe a case of HBV reactivation in a patient who underwent kidney transplantation more than 30 years ago, with a known serological profile of past HBV infection.
Results: Reactivation occurred as a highly replicative infection that went undiagnosed for 7 years due to negative results for HB surface antigen (HBsAg) and high levels of anti-HBs antibodies. Viral genome sequencing showed a high number of mutations in the major hydrophilic region of HBsAg that could explain such a profile.
Discussion: This case highlights the usefulness of frequent and systematic HBV viral load testing in patients at risk of reactivation, with anti-hepatitis B core antibodies, regardless of HBsAg detection, aminotransferases, and anti-HBs antibody levels.
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