慢性乙型肝炎表面抗原丢失患者的动态变化1例报告。

IF 3 3区 医学 Q2 INFECTIOUS DISEASES
Chong Wang, Lin Lin, Da Peng Ding
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引用次数: 0

摘要

背景:乙型肝炎病毒(HBV)感染仍然是一个重大的全球健康挑战,特别是在中国等地区,HBV携带者的患病率很高。我们报道了一例表现出HBsAg丢失和随后逆转的慢性HBV患者的动态血清学和病毒学变化,探讨了非典型血清学特征的复杂分子机制。病例介绍:65岁男性,40年慢性HBV感染史,并发肝细胞癌(HCC)。在三年多的时间里,患者接受了多种干预,包括经动脉化疗栓塞(TACE)和靶向治疗。连续监测显示HBsAg水平逐渐下降,导致血清阴性,两年后HBsAg恢复。HBsAg血清阴性时,测定HBV DNA水平为1.45 × 10³IU/mL。遗传分析确定了HBV S基因的多个突变,可能改变HBsAg结构和抗原性,导致非典型血清学特征。结论:该病例强调了慢性感染和癌症治疗背景下HBV血清学动力学的复杂性。观察到的HBsAg波动突出了对慢性HBV患者,特别是接受免疫抑制治疗的患者进行警惕监测和先进诊断技术(如HBV DNA检测)的必要性。所鉴定的S基因突变可能解释血清学变化,强调遗传分析对了解HBV演变和指导临床治疗的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Dynamic changes of chronic hepatitis B patient with loss of surface antigen: a case report.

Background: Hepatitis B virus (HBV) infection remains a significant global health challenge, particularly in regions like China, where the prevalence of HBV carriers is high. We report the dynamic serological and virological changes in a chronic HBV patient who exhibited HBsAg loss and subsequent reversion, explore the complex molecular mechanisms of atypical serological profile.

Case presentation: A 65-year-old male with a 40-year history of chronic HBV infection presented with hepatocellular carcinoma (HCC). Over three years, the patient underwent multiple interventions, including transarterial chemoembolization (TACE) and targeted therapies. Serial monitoring revealed a gradual decline in HBsAg levels, leading to seronegativity, followed by HBsAg reversion two years later. HBV DNA levels were quantified at 1.45 × 10³ IU/mL during HBsAg seronegativity. Genetic analysis identified multiple mutations in the HBV S gene, potentially altering HBsAg structure and antigenicity, contributing to the atypical serological profile.

Conclusions: This case underscores the complexity of HBV serological dynamics in the context of chronic infection and cancer treatment. The observed HBsAg fluctuations highlight the need for vigilant monitoring and advanced diagnostic techniques, such as HBV DNA testing, in patients with chronic HBV, particularly those undergoing immunosuppressive therapies. The identified S gene mutations may explain the serological changes, emphasizing the importance of genetic analysis in understanding HBV evolution and guiding clinical treatment.

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来源期刊
BMC Infectious Diseases
BMC Infectious Diseases 医学-传染病学
CiteScore
6.50
自引率
0.00%
发文量
860
审稿时长
3.3 months
期刊介绍: BMC Infectious Diseases is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of infectious and sexually transmitted diseases in humans, as well as related molecular genetics, pathophysiology, and epidemiology.
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